THE INCIDENCE OF ACTIVE TUBERCULOSIS IN A LARGE URBAN AREA
THE INCIDENCE OF ACTIVE TUBERCULOSIS IN A LARGE URBAN AREA
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DOI：
10.1093/oxfordjournals.aje.a115246
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发表时间：
1989-06-01
影响因子：
5
通讯作者：
DIRKS, JM
中科院分区：
文献类型：
--
作者：
ENARSON, DA;WANG, JS;DIRKS, JM
作者回顾了1970年至1985年间以人口为基础的登记新报告的所有活动性结核病病例，将加拿大不列颠哥伦比亚省的大城市地区与大部分农村地区进行比较。尽管农村地区的发病率稳步下降，但城市地区的发病率却没有下降。在城市地区，结核病发病率与社会经济水平之间存在显著关系。据观察，在加拿大出生的人群中，男性的发病率高于女性，从未结婚的男性的发病率高于已婚男性，这种差异在人口普查区群体中不再存在。发病率差异最大的是失业男性和在职男性。最贫穷人口普查区的病例通常患有晚期传染性肺病，而且更有可能是酗酒者。最贫穷人口普查区的结核病发病率下降的速度不如其他地区快。结核病在最贫穷的城市人口普查区的特点表明，有结核病风险的人可能有选择地移徙，这种疾病可能继续传播，因此需要制定富有想象力的病例发现和治疗方案来解决这一问题。
The authors reviewed all cases of active tuberculosis newly reported to a population-based registry between 1970 and 1985 to compare a large urban area with the mostly rural remainder of the province of British Columbia, Canada. Although incidence rates have declined steadily in the rural area, they have not done so in the urban area. Within the urban area, there was a striking relation between tuberculosis incidence and socioeconomic level. Incidence rates in those born in Canada were observed to be higher for men than for women and higher for men who had never married than for those who had ever married, a difference no longer present within census tract groups. The greatest difference in incidence was between unemployed and employed men. Cases in the poorest census tracts more commonly had advanced, infectious pulmonary disease and were more likely to be alcoholics. The incidence of tuberculosis in the poorest census tracts did not decline as rapidly as in other areas. The characteristics of the disease in the poorest urban census tracts suggest the possibility of selective migration of persons at risk for tuberculosis and of continuing transmission of the disease and call for imaginative case-finding and treatment programs to address this problem.