美国COVID-19流行病对结核病结果的影响:贝叶斯分析
Nicole A Swartwood1, Ted Cohen2, Suzanne M Marks3
1Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
概括
在美国,COVID-19大流行严重影响了结核病 (TB),导致到2035年,成千上万的TB病例和死亡人数增加. 诸如诊断率和接触模式等因素对结核病趋势产生了复杂的抵消作用.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 传染病建模传染病建模
背景情况:
- 在美国,结核病 (TB) 发病率和死亡率在COVID-19大流行期间经历了显著的波动.
- 了解这些变化的驱动因素对于未来的公共卫生战略至关重要.
研究的目的:
- 分析COVID-19流行病对美国结核病通知和死亡的影响.
- 估计未来的结核病趋势,并确定从2020年到2035年的贡献因素.
主要方法:
- 利用贝叶斯的方法来合成有关移民,呼吸道接触率,诊断/治疗开始和结核病死亡率的数据.
- 采用传输动态模型,将与流行病相关的机制变化与结核病结果联系起来.
- 模拟反事实场景,以隔离大流行的影响,并预测到2035年的结果.
主要成果:
- 据估计,到2035年,有2,784个额外的结核病通知和1,138个额外的结核病死亡与流行病相关的变化有关.
- 结核病诊断率的降低增加了死亡和通报,而接触率的降低降低了死亡和通报.
- 移民转移最初降低了结核病死亡人数,但随着时间的推移而增加;较高的结核病死亡率增加了死亡人数,但降低了通知.
结论:
- COVID-19大流行对结核病的直接影响发生在2020-2023年,但将继续影响结核病发病率和死亡率多年.
- 关键机制的流行病相关变化对结核病流行病学产生了复杂而有时又相反的影响.
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