Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis
Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis
复制标题
DOI：
10.2471/blt.11.089441
复制
发表时间：
2011-12-01
期刊：
影响因子：
--
通讯作者：
Cole, Donald C
中科院分区：
文献类型：
--
作者：
Denning, David W;Pleuvry, Alex;Cole, Donald C
目的评估肺结核（PTB）后慢性肺曲霉菌病（CPA）的全球负担，特别是肺空洞的病例。方法从世界卫生组织（WHO）获得PTB发病率，并对文献进行范围回顾，以确定PTB后残余肺空洞的研究，并估计PTB后CPA的全球发病率。在确定21%（美国）至35%（中国台湾）的PTB患者发生肺空洞，其中约22%的患者发生CPA后，作者采用10%、15%和25%的年脱落率估计了5年内CPA的周期患病率范围。分析是基于一个确定性的model.Findings在2007年，770万例PTB发生在全球范围内，其中，估计372 000开发CPA：从11 400在欧洲到145 372在东南亚。全球5年期患病率分别为117.4万、85.2万和137.2万例，年脱落率分别为15%、25%和.10%。流行率从西欧大国和美利坚合众国的每10万人中不到1例到刚果民主共和国和尼日利亚的每10万人中42.9例不等。中国和印度的中间五年期患病率为16.2和23.1每100000，respectively。结论CPA作为PTB的续集的全球负担是巨大的，值得进一步调查。CPA可以解释一些涂阴肺结核病例。由于CPA对长期抗真菌治疗有反应，因此应紧急进行病例检测。
Objective To estimate the global burden of chronic pulmonary aspergillosis (CPA) after pulmonary tuberculosis (PTB), specifically in cases with pulmonary cavitation.Methods PTB rates were obtained from the World Health Organization and a scoping review of the literature was conducted to identify studies on residual pulmonary cavitation after PTB and estimate the global incidence of CPA after PTB. Having established that from 21% (United States of America) to 35% (Taiwan, China) of PTB patients developed pulmonary cavities and that about 22% of these patients developed CPA, the authors applied annual attrition rates of 10%, 15% and 25% to estimate the period prevalence range for CPA over five years. Analysis was based on a deterministic model.Findings In 2007, 7.7 million cases of PTB occurred globally, and of them, an estimated 372 000 developed CPA: from 11 400 in Europe to 145 372 in South-East Asia. The global five-year period prevalence was 1 174 000, 852 000 and 1 372 000 cases at 15%, 25% and .10% annual attrition rates, respectively. The prevalence rate ranged from < 1 case per 100 000 population in large western European countries and the United States of America to 42.9 per 100 000 in both the Democratic Republic of the Congo and Nigeria. China and India had intermediate five-year period prevalence rates of 16.2 and 23.1 per 100000, respectively.Conclusion The global burden of CPA as a sequel to PTB is substantial and warrants further investigation. CPA could account for some cases of smear-negative PTB. Since CPA responds to long-term antifungal therapy, improved case detection should be urgently undertaken.