结核病控制的发展以及减少全球结核病发病率,流行率和死亡率的前景
Christopher Dye1, Catherine J Watt, Daniel M Bleed
1Stop TB Department, World Health Organization, Geneva, Switzerland. dyec@who.int
JAMA
|June 9, 2005
概括
结核病 (TB) 控制计划取得进展,全球病例检测和治疗成功率有所增加. 然而,到2015年实现千年发展目标需要加大努力,特别是在非洲和东欧.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 全球卫生政策 全球卫生政策
背景情况:
- 联合国千年发展目标 (MDGs) 推动了对结核病 (TB) 控制策略的评估,如DOTS.
- 评估DOTS和其他结核病控制措施的影响对于全球卫生目标至关重要.
研究的目的:
- 评估到2015年实现结核病控制千年发展目标的可行性.
- 关键目标包括检测70%的新的涂抹阳性病例,成功治疗85%,并减少结核病发病率,流行率和死亡率.
主要方法:
- 利用了多达200个国家的结核病例通知,队列治疗结果,死亡登记和流行调查 (1980-2003).
- 数据来源于世卫组织的全球结核病数据库,包括DOTS和非DOTS计划.
- 估计到2015年为9个不同的全球地区的结核病发病率,流行率和死亡率.
主要成果:
- 2003年,全球结核病发病率上升,但在9个地区中的7个地区,结核病发病率稳定或下降,不包括受艾滋病毒影响的非洲部分地区.
- 在2003年,DOTS病例检测显著改善,达到45%,预计到2005年将达到60%.
- 自1998年以来,整体治疗成功率超过了80%,尽管区域差异仍然存在,非洲和东欧的治疗成功率最低.
结论:
- 实现到2015年减少结核病的千年发展目标对大多数地区来说是可能的.
- 非洲和东欧仍然面临重大挑战,需要加强结核病控制工作.
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