Tuberculosis control and elimination 2010-50: cure, care, and social development
Tuberculosis control and elimination 2010-50: cure, care, and social development
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DOI：
10.1016/s0140-6736(10)60483-7
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发表时间：
2010-05-22
期刊：
影响因子：
168.9
通讯作者：
Raviglione, Mario C.
中科院分区：
文献类型：
--
作者：
Loennroth, Knut;Castro, Kenneth G.;Raviglione, Mario C.
世卫组织建议的结核病诊断和治疗的标准化方法迅速扩大，使1995年至2008年期间有3600多万人得到治愈，避免了多达600万人死亡。然而，结核病仍然是一个严重的全球公共卫生威胁。全世界每年有900多万新病例，发病率以每年不到1%的速度下降。虽然与制止和开始扭转艾滋病流行的千年发展目标有关的总目标在2004年可能已经实现，但目前的战略和文书将无法实现为2050年设定的更重要的长期消除目标。几个关键挑战依然存在。许多弱势群体无法获得负担得起的高质量服务。诊断、治疗和预防技术陈旧且不充分。耐多药结核病在许多情况下是一种严重威胁。艾滋病毒/艾滋病继续助长结核病的流行，特别是在非洲。此外，其他风险因素和潜在的社会决定因素有助于在社区维持结核病。加速这一下降，实现消灭这一疾病，将需要在四个广泛领域采取积极行动：根据控制结核病战略，继续扩大对所有形式结核病的早期诊断和适当治疗；制定和执行大胆的卫生系统政策；与更广泛的发展议程建立联系；促进和加强创新研究。
Rapid expansion of the standardised approach to tuberculosis diagnosis and treatment that is recommended by WHO allowed more than 36 million people to be cured between 1995 and 2008, averting up to 6 million deaths. Yet tuberculosis remains a severe global public health threat. There are more than 9 million new cases every year worldwide, and the incidence rate is falling at less than 1% per year. Although the overall target related to the Millennium Development Goals of halting and beginning to reverse the epidemic might have already been reached in 2004, the more important long-term elimination target set for 2050 will not be met with present strategies and instruments. Several key challenges persist. Many vulnerable people do not have access to affordable services of sufficient quality. Technologies for diagnosis, treatment, and prevention are old and inadequate. Multidrug-resistant tuberculosis is a serious threat in many settings. HIV/AIDS continues to fuel the tuberculosis epidemic, especially in Africa. Furthermore, other risk factors and underlying social determinants help to maintain tuberculosis in the community. Acceleration of the decline towards elimination of this disease will need invigorated actions in four broad areas: continued scale-up of early diagnosis and proper treatment for all forms of tuberculosis in line with the Stop TB Strategy; development and enforcement of bold health-system policies; establishment of links with the broader development agenda; and promotion and intensification of research towards innovations.