耐药结核病的趋势和预测:从GBD研究2021的全球视角
Yi Guo1, Jiacheng Li2, Lihong Lin1
1Department of Nosocomial Infection Control, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China.
Frontiers in public health
|April 10, 2025
概括
耐药结核病 (DRTB) 趋势显示,多耐药结核病 (MDRTB) 主导低收入地区,而广泛耐药结核病 (EDRTB) 在发达地区上升. 预测显示,到2030年,全球DRTB将减少,重点是早期诊断和治疗.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 由Mycobacterium tuberculosis引起的结核病 (TB) 给全球健康带来了重大挑战.
- 耐药结核病 (DRTB),包括多耐药结核病 (MDRTB) 和广泛耐药结核病 (EDRTB),是对控制工作日益关注的问题.
研究的目的:
- 从1991年到2021年分析MDRTB和EDRTB的年龄标准化发病率 (ASIR) 变化.
- 调查DRTB的区域和国家一级流行病学变异.
- 使用自回归集成移动平均 (ARIMA) 模型预测未来的DRTB趋势.
主要方法:
- 利用了来自全球疾病负担 (GBD) 数据库 (19912021) 的数据.
- 计算估计的年度百分比变化 (EAPC),以量化DRTB ASIR的时间趋势.
- 应用ARIMA建模用于流行病学趋势预测 (20222030).
主要成果:
- 全球DRTB的组成发生了转变:发达地区的EDRTB增加,撒哈拉以南非洲的MDRTB仍然占主导地位.
- 2021年最高的ASIR:索马里的MDRTB,摩尔多瓦的EDRTB.
- 观察到显著的区域差异,包括东亚的MDRTB下降和大洋洲的增加;国家一级的趋势差异很大.
结论:
- 在社会人口统计指数 (SDI) 较低的地区,MDRTB继续占主导地位,而在高SDI的地区,EDRTB预计将下降.
- 改进的诊断和治疗方法正在影响DRTB趋势.
- 预计到2030年,全球DRTB负担将减少,因此需要专注于早期诊断和优化治疗策略.
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