在纽约布朗克斯的儿童结核病,纽约
E Drucker1, P Alcabes, W Bosworth
1Department of Epidemiology and Social Medicine, Monteflore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467-2490.
Lancet (London, England)
|June 11, 1994
概括
贫困和拥挤的住房仍然是城市地区儿童结核病 (TB) 的重要风险因素. 即使人类免疫缺陷病毒 (HIV) 流行,过度拥挤也会大大增加儿童的结核病风险.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 环境健康 环境健康
背景情况:
- 从1978年到1992年,在纽约市 (NYC) 肺结核 (TB) 的复苏与艾滋病流行病有关.
- 城市贫困地区活跃结核病例的增加表明社区暴露的增加.
- 该研究集中在布朗克斯,研究了艾滋病率,住宅拥挤和幼儿活跃结核病之间的关系.
研究的目的:
- 调查社区层面的获得性免疫缺陷综合征 (艾滋病) 率与居住区拥挤与布朗克斯五岁以下儿童活跃结核病例之间的生态关联.
- 了解历史风险因素 (贫困,拥挤) 与新风险因素 (艾滋病毒) 在结核病复发中的作用.
主要方法:
- 利用了1986年至1992年期间在布朗克斯报告的75起儿童结核病例的数据.
- 住宅拥挤的定义是家庭的百分比,每个房间超过一个人.
- 采用波桑回归来建模社区艾滋病毒负担 (按成年女性艾滋病死亡率近似计算) 和住宅拥挤对结核病风险的影响,并按卫生领域汇总数据.
主要成果:
- 从1970年到1990年,在布朗克斯的结核病率和住宅拥挤之间观察到明显的时间相关性.
- 住房拥挤与贫困,公共援助依赖,家庭规模更大,西班牙裔族裔以及更高比例的幼儿有关.
- 儿童结核病发病率随着家庭拥挤而增加,从每10,000名儿童中的1.47例上升到超过8例.
- 即使在控制艾滋病毒负担后,严重拥挤的住房 (超过12%的家庭) 的儿童患有活跃结核病的风险增加了5.6倍.
结论:
- 虽然人类免疫缺陷病毒 (HIV) 感染是结核病复发的关键因素,但贫困和家庭拥挤等传统风险因素仍然非常重要.
- 调查结果强调了社会经济条件和生活密度对结核病传播和脆弱人群的发病率的持续影响.
- 解决贫困和住房条件的干预措施对于控制结核病至关重要,特别是在艾滋病毒流行率高的城市环境中.
相关概念视频
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