Global incidence of multidrug-resistant tuberculosis
Global incidence of multidrug-resistant tuberculosis
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DOI：
10.1086/505877
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发表时间：
2006-08-15
影响因子：
6.4
通讯作者：
Dye, Christopher
中科院分区：
文献类型：
--
作者：
Zignol, Matteo;Hosseini, Mehran S.;Dye, Christopher
背景据估计，2000年全球耐多药（MDR）结核病（TB）病例数为272，906例（95%置信区间[CI]，184，948 - 414，295）。为了准确规划结核病控制项目，已使用来自其他国家的数据并通过在模型中纳入以前治疗过的结核病例（在以前的分析中未考虑）对这一估计和其他估计进行了修订。采用多元逻辑回归分析确定了分别在90个和77个国家调查的新病例和既往治疗病例中预测耐多药结核病发生率的变量。然后用这些变量估计未调查国家的耐多药结核病频率。据估计，2004年全世界发生的耐多药结核病例总数为424，203例（95% CI，376，019 - 620，061），占所有新发和既往治疗结核病例的4.3%（95% CI，3.8%-6.1%）。同年，仅在先前接受过治疗的结核病例中估计就发生了181，408例（95% CI，135，276 - 319，017）耐多药结核病例。三个国家--中国、印度和俄罗斯联邦--占261，362例（95%CI，180，779 - 414，749）耐多药结核病例，占估计全球负担的62%。这些最新的估计数包含了以前治疗过的结核病例，因此需要制定紧急计划，在资源匮乏的环境中扩大对耐多药结核病患者的适当诊断和治疗服务。
Background. The global number of incident cases of multidrug-resistant (MDR) tuberculosis (TB) in 2000 was estimated to be 272,906 (95% confidence interval [CI], 184,948-414,295). For accurate planning of TB control programs, this estimate and others have been revised using data from additional countries and by including in the model previously treated TB cases, which had not been accounted for in the previous analysis.Methods. Multiple logistic regression was used to identify variables that were predictive of MDR-TB frequency among new and previously treated cases surveyed in 90 and 77 countries, respectively. These variables were then used to estimate MDR-TB frequencies in countries that had not been surveyed.Results. The total number of MDR-TB cases estimated to have occurred worldwide in 2004 is 424,203 (95% CI, 376,019-620,061), or 4.3% (95% CI, 3.8%-6.1%) of all new and previously treated TB cases. In the same year, 181,408 (95% CI, 135,276-319,017) MDR-TB cases were estimated to have occurred among previously treated TB cases alone. Three countries-China, India, and the Russian Federation-accounted for 261,362 (95% CI, 180,779-414,749) MDR-TB cases, or 62% of the estimated global burden.Conclusions. These updated sets of estimates incorporating previously treated TB cases call for an urgent plan to expand appropriate diagnostic and treatment services for patients with MDR-TB in low-resource settings.