Banerjee A, Harries A D, Salaniponi F M
National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi.
Trans R Soc Trop Med Hyg. 1999 Jul-Aug;93(4):392-3. doi: 10.1016/s0035-9203(99)90128-1.
There has been a large upsurge of tuberculosis (TB) in many countries in sub-Saharan Africa, mainly as a result of the co-existing human immunodeficiency virus (HIV) epidemic. Malawi has had a well-run National TB Control Programme (NTP) with good registration and recording of cases. For some years the NTP has had the impression that TB in the country is concentrated around townships and is less prevalent in the rural areas. This impression was investigated in a rural district (Ntcheu District) in Malawi. Data on new TB cases were collected from the district TB register for the years 1992-96 and average annual TB incidence rates per 100,000 for semi-urban and rural populations were calculated for this period. There was a significantly higher incidence of TB, particularly amongst cases with smear-negative pulmonary TB and extrapulmonary TB, in the semi-urban population compared with the rural population. Possible explanations could be higher HIV seroprevalence rates in semi-urban areas compared with rural areas, under-diagnosis at health centres or poor access to medical facilities for rural people.
撒哈拉以南非洲的许多国家结核病（TB）大量激增，主要是由于同时存在的人类免疫缺陷病毒（HIV）流行。马拉维拥有运作良好的国家结核病控制规划（NTP），对病例进行了良好的登记和记录。多年来，NTP一直认为该国的结核病集中在城镇地区，农村地区的患病率较低。在马拉维的一个农村地区（恩彻乌区）对这一印象进行了调查。从该地区1992 - 1996年的结核病登记册中收集了新结核病病例的数据，并计算了这一时期半城市和农村人口每10万人的平均年结核病发病率。与农村人口相比，半城市人口中结核病的发病率显著更高，特别是在涂片阴性肺结核和肺外结核病例中。可能的解释是，与农村地区相比，半城市地区的HIV血清阳性率更高、卫生中心诊断不足或农村人口获得医疗设施的机会较差。
