Wolleswinkel-van den Bosch J H, Nagelkerke N J D, Broekmans J F, Borgdorff M W
Pallas, Health Research and Consultancy, Rotterdam, The Netherlands.
Int J Tuberc Lung Dis. 2002 Feb;6(2):130-6.
To determine whether elimination of tuberculosis in the Dutch population can be achieved by the year 2030, taking into account the impact of immigration.
The incidence of tuberculosis (all forms) in the period 1970 to 2030 was estimated using a life-table model for the Dutch population without the impact of immigration. The influence of immigration on tuberculosis incidence among the Dutch was modelled using four immigrant scenarios, distinguished by the assumed contact rate between immigrants and the Dutch population, and by different projections (middle, upper) of the future size of the immigrant population in The Netherlands.
The incidence of smear-positive tuberculosis among the Dutch is projected to be 1.4 per million in the scenario without the influence of immigrant cases, and ranging from 3.8 to 11.8 per million in the four immigrant scenarios. In all immigrant scenarios, the prevalence of tuberculosis infection will continue to decline and be less than 1% by the year 2030. At least 60% of Dutch tuberculosis cases in the year 2030 are expected to be the result of transmission from a foreign source case.
Using a prevalence of tuberculosis infection of less than 1% as the elimination criterion, tuberculosis will probably be eliminated from the indigenous Dutch population by 2030. However, the incidence of smear-positive tuberculosis is expected to remain higher than 1 per million, and the majority of new tuberculosis cases among the Dutch may be attributable to recent infection from a foreign source case.
考虑到移民的影响，确定荷兰人口到2030年能否实现结核病消除。
使用生命表模型估计了1970年至2030年期间荷兰人口（不考虑移民影响）的结核病（所有类型）发病率。通过四种移民情景模拟了移民对荷兰结核病发病率的影响，这四种情景根据假设的移民与荷兰人口之间的接触率以及荷兰未来移民人口规模的不同预测（中等、高）来区分。
在无移民病例影响的情景下，预计荷兰涂片阳性结核病的发病率为每百万人口1.4例，在四种移民情景下发病率为每百万人口3.8至11.8例。在所有移民情景中，结核病感染患病率将持续下降，到2030年将低于1%。预计2030年至少60%的荷兰结核病病例将是由国外传染源传播所致。
以结核病感染患病率低于1%作为消除标准，到2030年荷兰本土人口可能实现结核病消除。然而，预计涂片阳性结核病的发病率将保持在每百万人口高于1例，荷兰大多数新结核病病例可能归因于近期来自国外传染源的感染。
