Frieden Thomas R
Regional Office for South-East Asia, World Health Organization, New Delhi, India.
Int J Epidemiol. 2002 Oct;31(5):894-9. doi: 10.1093/ije/31.5.894.
Tuberculosis (TB) is nearly 100% curable. However, the ability of medical and public health interventions to control TB, particularly in developing countries, is often doubted.
We reviewed data for the amenability of TB to control. We considered separately control of deaths, prevalence, rate of infection and incidence.
Tuberculosis mortality can be reduced by more than 80% in less than 5 years. The prevalence of TB can be reduced by 30% or more annually; sustained annual decreases of 17% have been documented in a developing country. The TB infection rate can be reduced by 15% annually. In the absence of human immunodeficiency virus (HIV), TB incidence can be decreased by as much as 25% per year and up to 10% annually in developing countries. A high prevalence of untreated HIV infection in the adult population of a developing country will inevitably result in a significant increase in TB incidence despite optimal use of currently available technologies.
Tuberculosis can be controlled if appropriate policies are followed, effective clinical and public health management is ensured, and there are committed and co-ordinated efforts from within and outside the health sector. However, in the context of a large epidemic of AIDS, TB incidence will inevitably increase. By 2001, less than 30% of global TB cases were reported to have received effective diagnosis, treatment and monitoring. Rapid expansion of effective TB control services is urgently required, both to avert the continued high burden of morbidity and mortality from TB and because of the HIV pandemic.
结核病几乎100%可治愈。然而，医疗和公共卫生干预措施控制结核病的能力，尤其是在发展中国家，常常受到质疑。
我们回顾了结核病可控制程度的数据。我们分别考虑了对死亡、患病率、感染率和发病率的控制情况。
在不到5年的时间里，结核病死亡率可降低80%以上。结核病患病率每年可降低30%或更多；在一个发展中国家，已记录到持续每年下降17%。结核病感染率每年可降低15%。在没有人类免疫缺陷病毒（HIV）的情况下，结核病发病率每年可降低多达25%，在发展中国家每年可降低10%。尽管最佳利用了现有技术，但发展中国家成年人口中未经治疗的HIV感染率很高，这将不可避免地导致结核病发病率大幅上升。
如果遵循适当的政策，确保有效的临床和公共卫生管理，并且卫生部门内外做出坚定和协调的努力，结核病是可以得到控制的。然而，在艾滋病大规模流行的背景下，结核病发病率将不可避免地上升。到2001年，据报告全球不到30%的结核病病例得到了有效的诊断、治疗和监测。迫切需要迅速扩大有效的结核病控制服务，以避免结核病继续造成高发病率和高死亡率负担，也是由于艾滋病毒大流行的缘故。
