The global emergency of tuberculosis: what is the cause?
The global emergency of tuberculosis: what is the cause?
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DOI：
10.1177/146642400212200206
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发表时间：
2002-06-01
期刊：
影响因子：
--
通讯作者：
Zumla, A
中科院分区：
文献类型：
--
作者：
Grange, JM;Zumla, A
结核病的治疗费用低廉且高效，但在世界范围内，这种疾病仍然是导致疾病和死亡的严重原因;其严重程度已于1993年被宣布为“全球紧急情况”。结核病主要是一种贫困疾病，95%的病例和98%的死亡发生在发展中国家，结核病的发病率在世界范围内不断上升，部分原因是贫困和不平等，部分原因是艾滋病毒/艾滋病的流行，这大大增加了感染发展为明显疾病的风险。约30%的艾滋病相关死亡是由结核病引起的，耐多药结核病（MDRTB）的出现对结核病控制构成了越来越大的威胁。虽然可以用替代药物治疗，但费用巨大，因此许多贫穷国家没有采取行动。虽然全球耐多药结核病的总体发病率较低，但它发生在包括俄罗斯监狱在内的某些“热点”地区。由于不利的社会经济因素，伦敦未能逃脱发病率的普遍上升，在没有引入积极控制策略的情况下，有可能发生一场像十年前纽约市发生的那样的严重流行病，需要巨大的财政支出来控制它。为了控制结核病，世卫组织的“遏制结核病”运动呼吁普遍采用其直接观察治疗、短期疗程（DOTS）战略。此外，通过大规模努力消除贫困疾病，一些国际机构正在敦促在全世界建立有效的控制规划。伦敦应该率先垂范。
The treatment of tuberculosis is cheap and highly effective, yet worldwide the disease remains a serious cause of illness and death; so serious as to have been declared a 'global emergency' in 1993. It is principally a disease of poverty, with 95% of cases and 98% of deaths occurring in developing countries.The incidence of tuberculosis is increasing worldwide, partly due to poverty and inequity and partly to the HIV/AIDS pandemic, which greatly increases the risk of infection proceeding to overt disease. Around 30% of AIDS-related deaths are due to tuberculosis.The emergence of multidrug resistant tuberculosis (MDRTB) is an increasing threat to tuberculosis control. Although treatable with alternative drugs, the cost is enormous and, accordingly, not undertaken in many poor nations. While the overall global incidence of MDRTB is low, it occurs in certain 'hotspots' including Russian prisons.Due to adverse socio-economic factors, London has not escaped the general rise in incidence and, without the introduction of active control strategies, there could be a serious epidemic as occurred in New York City ten years ago which required an enormous financial outlay for its control.In view of the global emergency of tuberculosis, the WHO 'Stop TB' campaign has called for the universal adoption of its directly observed therapy, short course (DOTS) strategy, Also, through the Massive Effort Against Diseases of Poverty, several international agencies are urging the establishment of effective control programmes worldwide. London should take the lead and set an example.