Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia.
Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia.
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DOI：
10.1371/journal.pone.0258809
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Pongpirul K
中科院分区：
文献类型：
--
作者：
Noviyani A;Nopsopon T;Pongpirul K
结核病在世界范围内造成了巨大的疾病负担和经济损失。由于没有诊断的金标准，及早识别结核病感染一直是具有挑战性的。这项研究的目的是对比调查印度尼西亚不同地理区域的结核病患病率。参与者的人口学变量和结核病筛查结果来自卫生部卫生研究和发展局结核病股(HRDA-MoH)。以结核病病例为分子，以15岁及以上人口为分母，计算15岁及以上人群中的肺结核患病率。不同地理区域和诊断方法的差异以患病率和95%可信区间(CI)表示。总共审查了67,944条记录。根据细菌学证据，印度尼西亚每100,000人中的结核病患病率为759人(95%可信区间：589.7-960.8)，不同地区之间存在差异：913人(95%可信区间696.7-1,176.7；苏门答腊岛)、593人(95%可信区间447.2-770.6；爪哇-巴厘岛)和842人(95%可信区间634.7-1,091.8；其他岛屿)。此外，不同诊断方法的结核病患病率也不同：256.5(痰AFB)、545(痰培养)、752.2(胸部X光)和894.9(痰基因检测)。根据AFB的痰，结核病患病率从216.6(95%可信区间146.5-286.8；爪哇-巴厘岛)、259.9(95%可信区间184.2-335.6；其他岛屿)到307.4(95%可信区间208.3-406.5；苏门答腊岛)。根据痰培养，结核病患病率从487.9(95%可信区间433.6-548.6；爪哇-巴厘岛)、635.9(95%可信区间564.9-715.1；苏门答腊岛)到2,129.8(95%可信区间1,664.0-2,735.6；其他岛屿)。根据胸部X光，结核病患病率从152.1(95%可信区间147.9-156.3；爪哇-巴厘岛)、159.2(95%可信区间154.1-164.3；苏门答腊岛)到864(95%可信区间809-921.4；其他岛屿)不等。根据痰基因检测，结核病患病率从838.7(95%可信区间748.4-900.8；爪哇-巴厘岛)、875年(95%可信区间775.4-934.2；苏门答腊岛)到941.2(95%可信区间663.6-992.3；其他岛屿)。结核病流行在不同地理区域之间的差异可能会被诊断方法混淆。这项研究得到了朱拉隆功大学机构审查委员会的批准(IRB第684/63号)。
Tuberculosis (TB) has contributed to a significant disease burden and economic loss worldwide. Given no gold standard for diagnosis, early identification of TB infection has been challenging. This study aimed to comparatively investigate the prevalence of TB across diagnostic approaches (sputum AFB, sputum culture, sputum genetic test, and chest x-ray) and geographical areas of Indonesia. Participant demographic variables and TB screening test results were obtained from the Tuberculosis Unit, Health Research and Development Agency, Ministry of Health (HRDA-MoH). The prevalence of pulmonary TB in populations aged 15 years and over was calculated using TB cases as a numerator and populations aged 15 years and over as a denominator. Variations across geographical areas and diagnostic approaches were expressed as prevalence and 95% confidence interval (CI). A total of 67,944 records were reviewed. Based on bacteriological evidence, the prevalence of TB per 100,000 in Indonesia was 759 (95% CI: 589.7–960.8) with variations across areas: 913 (95% CI 696.7–1,176.7; Sumatra), 593 (95% CI 447.2–770.6; Java-Bali), and 842 (95% CI 634.7–1,091.8; other islands). Also, the prevalence of TB varied across diagnostic approaches: 256.5 (sputum AFB), 545 (sputum culture), 752.2 (chest x-ray), and 894.9 (sputum genetic test). Based on sputum AFB, the TB prevalence varied from 216.6 (95% CI 146.5–286.8; Java-Bali), 259.9 (95% CI 184.2–335.6; other islands) to 307.4 (95% CI 208.3–406.5; Sumatra). Based on sputum culture, the TB prevalence ranged from 487.9 (95% CI 433.6–548.6; Java-Bali), 635.9 (95% CI 564.9–715.1; Sumatra), to 2,129.8 (95% CI 1,664.0–2,735.6; other islands). Based on chest x-ray, the TB prevalence varied from 152.1 (95% CI 147.9–156.3; Java-Bali), 159.2 (95% CI 154.1–164.3; Sumatra), to 864 (95% CI 809–921.4; other islands). Based on sputum genetic test, the TB prevalence ranged from 838.7 (95% CI 748.4–900.8; Java-Bali), 875 (95% CI 775.4–934.2; Sumatra), to 941.2 (95% CI 663.6–992.3; other islands). The variation of TB prevalence across geographical regions could be confounded by the diagnostic approaches. This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No. 684/63).
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