| 摘要: |
| 结核病是一个全球性的疾病,在被忽略近20年后又死灰复燃,成为当今世界一个主要的公共卫生问题.1993年,世界卫生组织因结核病的流行规模及控制全球结核病的迫切需要,宣布全球进入结核病紧急状态.中国是世界上人口最多的国家,位居全球结核病感染最严重的22个国家之首位.在20世纪80年代中晚期,美国也终止了其长期以来结核病的下降趋势,1992年美国结核病的发病率达到一个高峰.撒哈拉以南非洲地区是世界结核病例分布最多的三个区域之一,世界结核病发病率最高的15个国家有13个在这个地区内,并且HIV是这一区域结核病发病率最主要的单一预计因子.世界最严重的HIV相关结核病发病也是在这个区域.全球持续的严重结核感染状态,是由于贫困人口的增加和来自于结核高发病率国家的人口流动和HIV的影响,最主要的是没有维持必需的公共卫生组织及设施,以及错误的认为结核病已成为一个过去的问题.依靠现有的诊断和治疗方法,WHO推荐的DOT方案有效而经济,适用于全球在不同条件下的结核控制. |
| 关键词: 流行病学、中国、美国、撒哈拉以南非洲、结核病 |
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| Worldwide trends in epidemiology and control of tuberculosis |
| Gninafon Daniel,李兵,赵学维,修清玉,LI Bing,ZHAO Xue-wei,XIU Qing-yu |
| () |
| Abstract: |
| Tuberculosis (TB) is a global burden disease and is being resurrected as a major worldwide public health problem after two decades of neglect.In 1993,the World Health Organization (WHO) declared that TB had been a global emergency because of the scale of the epidemic and the urgent need to improve global tuberculosis control.China is one of the countries with the largest population,and also the top of the 22 TB high-burden countries in the world.In the United States,the longstanding downward trend in TB incidence was interrupted in the mid-to-late 1980s,where the national TB incidence peaked in 1992.Sub-Saharan Africa is one of the three regions to dominate the worldwide distribution of notified TB cases.Of the 15 countries with the highest estimated tuberculosis incidence rates in the world,13 are in sub-Saharan Africa,where HIV is the most important single predictor of tuberculosis incidence.The largest share of the global burden of HIV-related tuberculosis falls on this region.The reasons for the persisting global tuberculosis burden include increased poverty in some regions,immigration from countries with high tuberculosis prevalence,the impact of HIV,and most importantly,the failure to maintain the necessary public health infrastructure under the mistaken belief that tuberculosis was a problem of the past.Relying on currently available methods of diagnosis and treatment,the DOT strategy promoted by the WHO for global tuberculosis control is effective,affordable,and adaptable in different settings. |
| Key words: epidemiology China United States sub-Saharan Africa tuberculosis |
