Trends of Zambia's tuberculosis burden over the past two decades
Trends of Zambia's tuberculosis burden over the past two decades
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DOI：
10.1111/j.1365-3156.2011.02849.x
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发表时间：
2011-11-01
影响因子：
3.3
通讯作者：
Mwaba, Peter
中科院分区：
文献类型：
--
作者：
Kapata, Nathan;Chanda-Kapata, Pascalina;Mwaba, Peter
目的研究赞比亚1990-2010年间结核病报告率的趋势，并确定在结核病控制方面取得的进展。方法回顾1990-2010年间的结核病报告和结核病规划报告。结果确定了两个不同的结核病趋势时期：1990-2004年间呈上升趋势至高峰，2004-2010年间呈中度下降趋势。在过去的二十年里，治疗结果有所改善。由于诊断能力较差，关于儿童结核病、囚犯结核病和孕妇结核病趋势的数据仍然很少，也不可靠。由于缺乏进行药物敏感性检测的实验室服务，没有关于耐药结核病趋势的数据。结论1990-2000年结核病的增加恰逢艾滋病毒/艾滋病的增加。2004年至2010年期间结核病略有减少可归因于结核病护理的改善、DOTS的持续实施和结核病诊断服务的改善。世界卫生组织最近认可的用于活动性结核病病例快速诊断和耐药性检测的新诊断技术需要在国家结核病规划中实施，以发现更多病例，并提供流行病学和监测数据，从这些数据中获得用于指导结核病控制投资的证据基础。需要调整结核病和艾滋病毒服务，以实现更好的管理成果。
OBJECTIVES To study trends in Zambia's TB notification rates between 1990 and 2010 and to ascertain progress made towards TB control.METHODS Retrospective review of TB notification returns and TB programme reports for the period from 1990 to 2010.RESULTS Two distinct TB trend periods were identified: a period of rising trends up to a peak between 1990 and 2004 and a period of moderately declining trends between 2004 and 2010. Treatment outcomes improved over the two decades. Data on trends in paediatric TB, TB in prisoners and TB in pregnant women remain scanty and unreliable owing to poor diagnostic capability. There were no data available on trends on drug-resistant TB because of the lack of laboratory services to perform drug sensitivity testing.CONCLUSIONS The period of increasing TB between 1990 and 2000 coincided with an increase in HIV/AIDS. The period of slightly decreasing TB between 2004 and 2010 can be attributed to improved TB care, sustained DOTS implementation and improvement in TB diagnostic services. Newer diagnostics technologies for the rapid diagnosis of active TB cases and for drug-resistant testing, recently endorsed by the WHO, need to be implemented into the national TB programmes to detect more cases and to provide epidemiological and surveillance data from which to obtain an evidence base for guided investments for TB control. Alignment of TB and HIV services is required to achieve improved management outcomes.