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目的进一步掌握结核的流行动态、发展趋势,为制定结核病防治决策提供科学依据。方法收集国内、外结核的流行资料,分析结核病流行特征及原因。结果国外结核病例大幅度回升(1993-1996年全世界增加13%,2003年结核病患者超过700万);我国肺结核呈现高患病率(活动性肺结核患病率367/10万,估计病人数411万-490万;涂阳患病率为122/10万,估计病人数133万-168万;菌阳患病率为160/10万,估计病人数175万-218万)、高感染率、低递降率(2000年标化涂阳率为97/10万,与1990年相比,下降27.6%;1990-2000年递降率为3.2%;实施干预措施的项目地区1990-2000年涂阳患病率下降幅度为44.1%,而非项目地区为12.3%)、农村疫情高于城市(活动性肺结核患病率,西部为东部的1.70倍,农村为城市的2.01倍城市、城镇、农村的活动性肺结核和涂阳及菌阳患病率(1/10万)分别为198、319、397;73、109、131;110、129、171;)、病人耐药率高(总耐药率为27.8%,初始耐药率为18.6%,获得性耐药率为46.5%)。2004年1～6月,病死率为1.07‰(0.98‰～1.17‰)、与2003年病死率1.57‰相似(Poisson 分布,X~2=0.488,P>0.25);发病率为73.6058/10万、高于2003年发病率52.3624/10万(Poisson 分布,X~2=32488.53,P<0.001)。结论当前全球结核病的疫情严重,其传播已造成世界范围严重的公共卫生威胁之一。只有加强结核的预防,依法检疫和检测,发现传染源,控制传染源、传播途径,保护易感人群等综合预防措施,才能控制结核的传播,最终消灭结核病。
Objective To further grasp the epidemiological trend of tuberculosis and provide a scientific basis for formulating tuberculosis prevention and control decision-making. Methods The epidemic data of tuberculosis in China and abroad were collected and the epidemiological characteristics and causes of tuberculosis were analyzed. As a result, the number of tuberculosis cases in foreign countries rose sharply (13% increase in the world from 1993 to 1996 and more than 7 million TB patients in 2003); tuberculosis in our country showed a high prevalence (prevalence of active tuberculosis 367/10 million and estimated number of patients 411 Million -4.9 million; prevalence of smear was 122 / 100,000, the estimated number of patients 1.33 million -168 million; the prevalence of bacilli was 160 / 100,000, the estimated number of patients 1.75 million -2.18 million), high infection rates, Low descent rate (standardized rate of 97 / 100,000 in 2000, down 27.6% compared with 1990; the rate of decline was 3.2% from 1990 to 2000; the area of the project to implement the intervention of 1990-2000 smear positive The rate of decline was 44.1%, compared to 12.3% in non-project areas). Outbreaks in rural areas were higher than those in cities (prevalence of active tuberculosis, 1.70 times in the west and 2.01 times in urban areas, urban and rural areas The prevalence of tuberculosis and smear-positive bacteria and bacilli (1/10 million) were 198,319,397; 73,109,131; 110,129,171; respectively) 27.8%, initial resistance rate was 18.6% and acquired resistance rate was 46.5%). From January to June 2004, the case fatality rate was 1.07 ‰ (0.98 ‰ ~ 1.17 ‰), similar to the case fatality rate of 1.57 ‰ in 2003 (Poisson distribution, X ~ 2 = 0.488, P> 0.25); the incidence was 73.6058 / , Higher than the incidence in 2003 52.3624 / 100000 (Poisson distribution, X ~ 2 = 32488.53, P <0.001). Conclusions The current global outbreak of tuberculosis is grave and its spread has created one of the world’s serious public health threats. Only by strengthening TB prevention, quarantine and testing according to law, finding sources of infection, controlling sources of infection, transmission routes and protecting vulnerable populations can we control the spread of tuberculosis and ultimately eliminate tuberculosis.