Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts
Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts
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DOI：
10.1016/s1473-3099(13)70015-x
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发表时间：
2013-05-01
影响因子：
56.3
通讯作者：
Zumla, Alimuddin
中科院分区：
文献类型：
--
作者：
Marais, Ben J.;Loennroth, Knut;Zumla, Alimuddin
最近的全球疾病负担数据反映了人口和生活方式的重大变化，导致非传染性疾病的增加。大多数结核病高发国家面临着非传染性疾病和传染性疾病的巨大共同负担。传统的疾病特异性方法通常无法认识到非传染性和传染性疾病的护理、管理和控制一体化的共同特征和潜在协同作用。在资源有限的国家，越来越需要解决范围更广的重叠共病。结核病和艾滋病毒/艾滋病仍然是全球紧急情况。在撒哈拉以南非洲的成人、儿童和孕妇中，结核病和艾滋病毒合并感染之间的致命相互作用证明了对疾病管理和控制采取综合办法的必要性。此外，糖尿病、吸烟、酗酒、慢性肺部疾病、癌症、免疫抑制治疗、营养不良和结核病之间的联系也得到了充分的认识。在此，我们重点关注结核病护理与非传染性和传染性疾病管理战略相结合的互动、协同作用和挑战，同时不削弱现有国家结核病方案的功能。现在比以往任何时候都更需要为这些举措持续提供更多资金，这需要政治和供资者作出更多承诺。
Recent data for the global burden of disease reflect major demographic and lifestyle changes, leading to a rise in noncommunicable diseases. Most countries with high levels of tuberculosis face a large comorbidity burden from both non-communicable and communicable diseases. Traditional disease-specific approaches typically fail to recognise common features and potential synergies in integration of care, management, and control of non-communicable and communicable diseases. In resource-limited countries, the need to tackle a broader range of overlapping comorbid diseases is growing. Tuberculosis and HIV/AIDS persist as global emergencies. The lethal interaction between tuberculosis and HIV coinfection in adults, children, and pregnant women in sub-Saharan Africa exemplifies the need for well integrated approaches to disease management and control. Furthermore, links between diabetes mellitus, smoking, alcoholism, chronic lung diseases, cancer, immunosuppressive treatment, malnutrition, and tuberculosis are well recognised. Here, we focus on interactions, synergies, and challenges of integration of tuberculosis care with management strategies for non-communicable and communicable diseases without eroding the functionality of existing national programmes for tuberculosis. The need for sustained and increased funding for these initiatives is greater than ever and requires increased political and funder commitment.