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结核病是一个全球性的疾病,在被忽略近20年后又死灰复燃,成为当今世界一个主要的公共卫生问题。1993年,世界卫生组织因结核病的流行规模及控制全球结核病的迫切需要,宣布全球进入结核病紧急状态。中国是世界上人口最多的国家,位居全球结核病感染最严重的22个国家之首位。在20世纪80年代中晚期,美国也终止了其长期以来结核病的下降趋势,1992年美国结核病的发病率达到一个高峰。撒哈拉以南非洲地区是世界结核病例分布最多的三个区域之一,世界结核病发病率最高的15个国家有13个在这个地区内,并且HIV是这一区域结核病发病率最主要的单一预计因子。世界最严重的HIV相关结核病发病也是在这个区域。全球持续的严重结核感染状态,是由于贫困人口的增加和来自于结核高发病率国家的人口流动和HIV的影响,最主要的是没有维持必需的公共卫生组织及设施,以及错误的认为结核病已成为一个过去的问题。依靠现有的诊断和治疗方法,WHO推荐的DOT方案有效而经济,适用于全球在不同条件下的结核控制。
Tuberculosis is a global disease that, after being neglected for nearly two decades, is resurgent and has become a major public health problem in the world today. In 1993, the World Health Organization declared a global emergency of tuberculosis due to the epidemic scale of tuberculosis and the urgent need to control global tuberculosis. China is the most populous country in the world, ranking first in 22 countries with the most serious tuberculosis infection in the world. In the late 1980s, the United States also halted its long-term decline in tuberculosis. In 1992, the incidence of tuberculosis in the United States reached a peak. Sub-Saharan Africa is one of the three most widely distributed TB cases in the world, with 13 of the 15 most affected countries in the world having the highest TB incidence and HIV being the single most important predictor of TB prevalence in the region . The world’s worst HIV-related tuberculosis is also in the region. The persistent state of global severe tuberculosis in the world is due to the increase in the number of people living with poverty and the impact of population movements and HIV from countries with a high incidence of tuberculosis. Most importantly, the lack of necessary public health organizations and facilities and the mistaken belief that tuberculosis has been Become a problem of the past. Relying on existing diagnostic and therapeutic approaches, the WHO-recommended DOT regimen is effective and affordable for global tuberculosis control under different conditions.