The global situation of MDR-TB
The global situation of MDR-TB
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DOI：
10.1016/s1472-9792(02)00058-6
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发表时间：
2003-01-01
期刊：
影响因子：
3.2
通讯作者：
Espinal, MA
中科院分区：
文献类型：
--
作者：
Espinal, MA
自化疗引入之初，就有耐药性结核病的报告。然而，大多数证据仅限于发达国家。1992年，第三届世界结核病大会得出结论认为，关于耐多药结核病（耐多药结核病）的全球规模的最新信息很少，耐多药结核病被定义为至少对异烟肼和利福平的耐药性。通过1994年发起的世卫组织/国际结核病防治与发展联合会全球耐药性监测项目，大量可靠和准确的数据使我们能够了解耐多药结核病问题的严重性。现有数据表明，在全球范围内，耐多药结核病并不是一个与药物敏感结核病同等严重的问题（在调查的64个国家/地理地点中，中位数= 1%）。然而，耐多药结核病在世界特定地区处于危急水平。耐多药结核病的热点地区包括爱沙尼亚、拉脱维亚、俄罗斯的伊万诺沃州和托木斯克以及中国的河南省和浙江省。趋势证实，耐多药结核病仅限于地方流行，但证据还不是无可辩驳的，因为许多国家只提供了短期数据。世界上三分之二的国家，更重要的是，22个结核病高负担国家中的一半尚未提供数据。数学模型表明，2000年世界上估计的新结核病例中有3.2%（或273，000例）（95%置信区间：185，000和414，000）是耐多药结核病。采用DOTS预防耐药菌株的产生和谨慎引入二线药物治疗耐多药患者是适当控制/遏制耐多药结核病的首要任务。(C)2003爱思唯尔科技有限公司版权所有。
Drug-resistant tuberculosis has been reported since the early days of the introduction of chemotherapy. However, most of the evidence was Limited to developed countries. In 1992, the Third World Congress on Tuberculosis concluded that there was little recent information on the global magnitude of multidrug-resistant tuberculosis (MDR-TB), defined as resistance to at least isoniazid and rifampicin. Through the WHO/IUATLD Global Project on Drug-Resistance Surveillance launched in 1994, a large number of reliable and accurate data have allowed us to understand the magnitude of the problem of MDR-TB. The data available suggest that globally MDR-TB is not a problem (median = 1% in 64 countries/geographical sites surveyed) of the same magnitude as that of drug-susceptible tuberculosis. However, MDR-TB is at critical Levels in specific regions of the world. Hot spots for MDR-TB include Estonia, Latvia, the Oblasts of Ivanovo and Tomsk in Russia, and the provinces of Henan and Zhejiang Provinces in China. Trends confirm that MDR-TB is limited to Local epidemics but the evidence is not yet irrefutable, as many countries have only provided short-term data. Two-thirds of the world's countries and, more importantly, half of the 22 tuberculosis high-burden countries, have not yet provided data. Mathematical modelling suggests that 3.2% (or 273,000) of the world's estimated new tuberculosis cases (95% confidence intervals: 185,000 and 414,000) were MDR-TB in 2000. Adoption of DOTS to prevent the generation of resistant strains and careful introduction of second-line drugs to treat patients with MDR are the top priorities for proper control/containment of MDR-TB. (C) 2003 Elsevier Science Ltd. ALL rights reserved.