IMPACT OF THE HIV EPIDEMIC ON TRENDS IN TUBERCULOSIS IN ABIDJAN, COTE-DIVOIRE
IMPACT OF THE HIV EPIDEMIC ON TRENDS IN TUBERCULOSIS IN ABIDJAN, COTE-DIVOIRE
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DOI：
10.1016/0962-8479(95)90572-3
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发表时间：
1995-02-01
期刊：
影响因子：
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通讯作者：
DECOCK, KM
中科院分区：
文献类型：
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作者：
RICHARDS, SB;STLOUIS, ME;DECOCK, KM
环境：西非首都，在艾滋病毒迅速流行的十年中，结核病病例的人口通报情况良好。目的：评价艾滋病毒流行对科特迪瓦阿比让结核病的影响。设计：回顾1981年至1991年交替年份在该市登记的所有结核病病例的数据，并使用普查数据计算基于人口的发病率。同时，对1989年和1991年肺结核患者的HIV血清阳性率进行了系统的研究。结果：1981年，在阿比让发现艾滋病毒对健康的任何影响之前几年，结核病的发病率为每10万人155例。到1991年，艾滋病毒血清阴性者的结核病发病率下降了38%，降至每10万人96例；然而，43.6%的结核病患者感染了艾滋病毒，艾滋病毒感染者的结核病发病率为每10万人1104例（相对危险度为11.5,95%可信区间为10.8-12.3），总体观察到的结核病发病率为每10万人159例。1989年至1991年间，艾滋病毒感染导致结核病的人口归因风险从36%增加到40%。结论：艾滋病毒的流行扭转了过去十年阿比让结核病发病率急剧下降的预期，艾滋病毒感染对结核病发病率的影响可能正在加速。
Setting: West African capital city with excellent, population-based notification of tuberculosis cases during a decade with a rapidly emerging HIV epidemic.Objective: To evaluate the impact of the HIV epidemic on tuberculosis in Abidjan, Cote d'Ivoire.Design: Review of data on all cases of tuberculosis registered in the city in alternate years from 1981 to 1991 and calculation of population-based rates using census data. Also, systematic study of HIV seroprevalence among tuberculosis patients in 1989 and 1991.Results: In 1981, several years before any health consequences of HIV were discernible in Abidjan, the incidence of tuberculosis was 155 per 100 000. By 1991, the rate of tuberculosis among HIV-seronegative persons had decreased by 38% to 96 per 100 000; however, 43.6% of tuberculosis patients were HIV-infected, and the incidence of tuberculosis among HIV-infected persons was 1104 per 100 000 (relative risk 11.5, 95% CI 10.8-12.3), yielding an overall observed incidence of tuberculosis of 159 per 100 000 population. The population attributable risk of tuberculosis due to HIV infection increased from 36% to 40% between 1989 and 1991.Conclusions: The HIV epidemic has reversed the expected steep decline in tuberculosis in Abidjan over the past decade, and the impact of HIV infection on the incidence of tuberculosis may be accelerating.