Multidrug-resistant tuberculosis.
Multidrug-resistant tuberculosis.
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DOI：
10.1186/1471-2334-8-10
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发表时间：
2008-01-25
影响因子：
3.7
通讯作者：
McNerney R
中科院分区：
文献类型：
--
作者：
Zager EM;McNerney R
每年有近900万新病例，结核病仍然是地球上最可怕的疾病之一。在杜绝结核病伙伴关系和世卫组织的领导下，最近防治这一疾病的努力在一些国家取得了相当大的进展。然而，对主要抗结核药物具有抗药性的结核分枝杆菌突变株的出现对控制工作构成了致命威胁。耐多药结核病（MDR-TB）在世界所有地区都有报告。最近，一些国家出现了对二线药物也有抗药性的广泛耐药结核病。为了确保分配足够的资源来防止耐药性的出现和蔓延，必须了解这一问题的规模。在这篇文章中，我们提出，目前的方法来描述耐药结核病的流行病学是不足以达到这一目的，并主张在全球监测数据中包括人口为基础的统计。结核病的流行率是指特定人群中患病的个人比例，而耐药结核病的流行率通常是指对抗结核药物表现出耐药性的结核病病例比例。全球监测活动已确定东欧国家、前苏联和中国各地区耐多药结核病例比例较高，国际评论主要集中在迫切需要改善这些环境中的控制。据观察，撒哈拉以南非洲等其他区域的耐药病例比例较低。然而，如果考虑到耐药结核病新发病例在人口中的发生率，那么撒哈拉以南非洲国家是世界上耐多药结核病传播率最高的国家之一。我们建议在全球监测数据中纳入基于人口的统计数据，以便更好地为关于控制耐药结核病的辩论提供信息。对全球耐多药结核病数据进行重新评估以纳入基于人口的统计数据表明，撒哈拉以南非洲的耐药结核病问题比以前认为的更为严重。
With almost 9 million new cases each year, tuberculosis remains one of the most feared diseases on the planet. Led by the STOP-TB Partnership and WHO, recent efforts to combat the disease have made considerable progress in a number of countries. However, the emergence of mutated strains of Mycobacterium tuberculosis that are resistant to the major anti-tuberculosis drugs poses a deadly threat to control efforts. Multidrug-resistant tuberculosis (MDR-TB) has been reported in all regions of the world. More recently, extensively drug resistant-tuberculosis (XDR-TB) that is also resistant to second line drugs has emerged in a number of countries. To ensure that adequate resources are allocated to prevent the emergence and spread of drug resistance it is important to understand the scale of the problem. In this article we propose that current methods of describing the epidemiology of drug resistant tuberculosis are not adequate for this purpose and argue for the inclusion of population based statistics in global surveillance data. Whereas the prevalence of tuberculosis is presented as the proportion of individuals within a defined population having disease, the prevalence of drug resistant tuberculosis is usually presented as the proportion of tuberculosis cases exhibiting resistance to anti-tuberculosis drugs. Global surveillance activities have identified countries in Eastern Europe, the former Soviet Union and regions of China as having a high proportion of MDR-TB cases and international commentary has focused primarily on the urgent need to improve control in these settings. Other regions, such as sub-Saharan Africa have been observed as having a low proportion of drug resistant cases. However, if one considers the incidence of new tuberculosis cases with drug resistant disease in terms of the population then countries of sub-Saharan Africa have amongst the highest rates of transmitted MDR-TB in the world. We propose that inclusion of population based statistics in global surveillance data is necessary to better inform debate on the control of drug resistant tuberculosis. Re-appraisal of global MDR-TB data to include population based statistics suggests that the problem of drug resistant tuberculosis in sub-Saharan Africa is more critical than previously perceived.
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影响因子：
5.4
作者：
Kim, JY;Shakow, A;Farmer, P
通讯作者：
Farmer, P
影响因子：
6.4
作者：
Zignol, Matteo;Hosseini, Mehran S.;Dye, Christopher
通讯作者：
Dye, Christopher
影响因子：
11.8
作者：
Cohn, DL;Bustreo, F;Raviglione, MC
通讯作者：
Raviglione, MC
影响因子：
168.9
作者：
Gandhi, Neel R.;Moll, Anthony;Friedland, Gerald
通讯作者：
Friedland, Gerald
影响因子：
11.8
作者：
Nathanson E;Lambregts-van Weezenbeek C;Rich ML;Gupta R;Bayona J;Blöndal K;Caminero JA;Cegielski JP;Danilovits M;Espinal MA;Hollo V;Jaramillo E;Leimane V;Mitnick CD;Mukherjee JS;Nunn P;Pasechnikov A;Tupasi T;Wells C;Raviglione MC
通讯作者：
Raviglione MC