Dye C
Communicable Diseases Control, Prevention & Eradication, World Health Organization, Geneva, Switzerland.
Int J Tuberc Lung Dis. 2000 Dec;4(12 Suppl 2):S146-52.
The main task of global tuberculosis (TB) control over the next decade is to dramatically reduce TB deaths, the average duration of illness, and incidence--in that order. The best possible application of chemotherapy has the potential to cut the TB burden by more than 50% in 10 years. Mass screening for active TB has not generally been recommended, but the costs and benefits of targeted active case finding deserve further investigation. Among potential new tools for TB control, the biggest prize would be a high-efficacy vaccine that can produce long-lasting immunity. Now that good control programmes are becoming more widespread, new methods and indicators are needed to evaluate epidemiological impact. Even if morbidity and mortality are significantly reduced before 2010, tuberculosis infection will persist for much longer, acting as a sensitive indicator of public health, and as a marker of the quality of health services.
未来十年全球结核病控制的主要任务是依次大幅降低结核病死亡人数、疾病平均持续时间和发病率。化疗的最佳应用有可能在10年内将结核病负担降低50%以上。一般不建议进行大规模活动性结核病筛查，但针对性主动病例发现的成本效益值得进一步研究。在结核病控制的潜在新工具中，最大的收获将是一种能产生持久免疫力的高效疫苗。鉴于良好的控制方案正日益普及，需要新的方法和指标来评估流行病学影响。即使在2010年前发病率和死亡率显著降低，结核感染仍将持续更长时间，它是公共卫生的敏感指标，也是卫生服务质量的标志。
