Szczuka I
Zakład Epidemiologii i Organizacji Walki z Gruźlica, Instytutu Gruźlicy i Chorób Płuc.
Przegl Epidemiol. 2000;54(1-2):9-24.
Tuberculosis has been a major public health problem in Poland for many decades.
The aim of this investigation was to evaluated incidence, prevalence and mortality from TB in Poland in 1998 and to examine trends of TB incidence.
Individual date on tuberculosis cases reported to National TB Register and date of prevalence and mortality from TB were analysed.
The paper presents the epidemiological situation of TB in Poland in 1998. The year of 1998 was the fifth consecutive year of decline at TB incidence after previous years (1991-1993) of increase. In 1998 there were 13,302 newly registered TB cases, of which 1,476 were relapses. The incidence was 34.4 per 100,000 population, (30.6 were the new cases and 3.8 relapses). Relapses represented 11.1% of all new registered cases. The incidence in 1998 was 4.7% lower than in 1997, but the rate of decline was smaller than in previous year (9.3%). Among the total number of newly registered cases there were 7,501 cases (19.4 per 100,000) bacteriologically confirmed, of which 4,090 cases were sputum smear positive. The proportion of bacteriologically culture positive cases was 56.4% and of sputum smear positive -30.7% which is rather low, but similar to previous years. In view of sufficient network of laboratory services this low proportion of bacteriological confirmation of diagnosis may indicate low quality of bacteriological examinations. In 96.2% of cases the diagnosis was respiratory tuberculosis. Low proportion (3.8%) of non respiratory tuberculosis, which continuous for many years, may indicate inadequacies in diagnosis and registration of this form of disease. The incidence of tuberculosis increases with age, from 1.5 in children up to 67.3 among 65 and older. The proportion of cases in the age group 20-44 years is still high (38.1%). The incidence in men (47.4) is two times higher than in women (22.1), and in rural population higher than in urban--35.6 and 33.7 respectively. The prevalence of tuberculosis at the end of 1998 was 39.5 (15,284 cases), of which 56.2% were bacteriologically confirmed cases (8,593 cases). In the latter group there were 256 cases bacteriologically positive for longer than one year, and 541 cases resistant to at least 1 drug. The proportion of resistant cases (6.3%) is similar to previous years and does not seem to influence the overall effectiveness of chemotherapy.
In recent years incidence of TB in Poland decreased. The incidence of tuberculosis in Poland was about 2 times higher than the average for E.U. countries, but lower than in other Eastern European countries. The distance between Poland and countries with lowest incidence is estimated at 25-30 years.
几十年来，结核病一直是波兰的一个主要公共卫生问题。
本调查旨在评估1998年波兰结核病的发病率、患病率和死亡率，并研究结核病发病率的趋势。
分析了向国家结核病登记处报告的结核病病例的个人数据以及结核病的患病率和死亡率数据。
本文介绍了1998年波兰结核病的流行病学情况。1998年是继前几年（1991 - 1993年）上升之后结核病发病率连续下降的第五年。1998年新登记结核病病例13302例，其中1476例为复发病例。发病率为每10万人34.4例（新病例30.6例，复发3.8例）。复发病例占新登记病例总数的11.1%。1998年的发病率比1997年低4.7%，但下降速度比上一年（9.3%）小。新登记病例总数中，有7501例（每10万人19.4例）经细菌学确诊，其中4090例痰涂片阳性。细菌学培养阳性病例的比例为56.4%，痰涂片阳性病例的比例为30.7%，这一比例相当低，但与前几年相似。鉴于实验室服务网络充足，如此低的细菌学确诊诊断比例可能表明细菌学检查质量较低。96.2%的病例为呼吸道结核病。非呼吸道结核病比例较低（3.8%），且多年来一直如此，这可能表明这种疾病形式在诊断和登记方面存在不足。结核病发病率随年龄增长而上升，从儿童的1.5例到65岁及以上人群的67.3例。20 - 44岁年龄组的病例比例仍然很高（38.1%）。男性发病率（47.4）是女性（22.1）的两倍，农村人口发病率高于城市人口——分别为35.6和33.7。1998年底结核病患病率为39.5（15284例），其中56.2%为细菌学确诊病例（8593例）。在后者中，有256例细菌学阳性超过一年，541例对至少一种药物耐药。耐药病例比例（6.3%）与前几年相似，似乎并未影响化疗的总体效果。
近年来波兰结核病发病率下降。波兰的结核病发病率约为欧盟国家平均水平的两倍，但低于其他东欧国家。波兰与发病率最低国家之间的差距估计为25 - 30年。
