通过积极干预措施在香格里拉市消除结核病的可行性:一项数学研究
Mingshu Xu1, Yue He2, Qiao Liu2
1Shangrao Centre for Disease Control and Prevention, Shangrao City, China.
Frontiers in public health
|September 26, 2025
概括
积极的病例发现和结核病预防治疗是减少中国结核病发病率的关键. 3HP疗法在实现消除目标方面表现最有前途,特别是当与对老年患者的加强监测相结合时.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 数学建模的数学建模
背景情况:
- 消除结核病 (TB) 在中国面临重大挑战.
- 积极病例发现 (ACF) 和结核病预防疗法 (TPT) 对于降低结核病发病率至关重要.
- 了解传输动态对于优化控制策略至关重要.
研究的目的:
- 确定最佳干预策略,以消除中国香格里拉市的结核病.
- 通过传输动态模型评估ACF和TPT的有效性.
- 在类似的环境中指导有针对性的结核病控制工作.
主要方法:
- 一个季节性自回归集成移动平均 (SARIMA) 模型预测了COVID-19中断期间 (2020-2023) 的结核病发病率.
- 一个年龄分层的动态传播模型使用监测数据 (2008-2023) 来评估结核病传播模式.
- 该模型评估了包括ACF,LTBI查和TPT在内的干预措施.
主要成果:
- 该模型与报告的结核病数据相匹配 (R2 = 0.53,p < 0.001).
- 预防性治疗策略,特别是3HP疗法 (3个月每周服用利法丁+异化),显示出实现结核病消除目标的最大潜力.
- 3HP疗法,60%的TPT同意和50%的LTBI查,预计到2030年的发病率为15.27/100,000,到2035年的发病率为7.98/100,000.
结论:
- 目前的结核病控制工作需要加强,以实现消除目标.
- 将ACF与TPT结合起来是消除结核病的一个有希望的策略.
- 针对性干预和加强对高风险群体的监测,特别是老年人,对于未来的结核病消除目标至关重要.
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