Mwaba P, Maboshe M, Chintu C, Squire B, Nyirenda S, Sunkutu R, Zumla A
University of Zambia-University College London (UNZA-UCLMS) Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
S Afr Med J. 2003 Feb;93(2):149-52.
To review trends in the rates of tuberculosis (TB) case notifications over a 37-year period.
A retrospective study of Ministry of Health records on TB notifications between 1 January 1964 and 31 December 2000.
Zambia, sub-Saharan Africa.
Retrospective analysis of case-notification data for TB of the Zambia Ministry of Health annual returns.
Annual TB case-notification rates and trends over the past 37 years.
TB case-notification data from 1964 to 2000 show a 12-fold increase over the past two decades, and apparent gains in controlling TB seen in the 1960s and 1970s have been reversed over the past two decades. A stable situation during the period 1964-1984 (case-notification rate remained around 100 per 100,000 population) was followed by an exponential increase since the mid-1980s. The absolute number of new TB cases increased from 8,246 in 1985 (124/100,000) to 38,863 (409/100,000) in 1996 and 52,000 (512/100,000) in 2000. Comparison of case-notification rates over the past 2 decades with neighbouring countries (Zimbabwe, Malawi and Tanzania) show that Zambia has one of the highest case-notification rates in the region.
Zambia, like many countries in Africa, is in the midst of a serious TB epidemic and there are no signs that it is abating. This increase was most likely due to the impact of the HIV/AIDS epidemic and subsequent breakdown of TB services. Concerted donor-government efforts should invest appropriately in long-term plans for TB control.
回顾37年间结核病病例通报率的变化趋势。
对1964年1月1日至2000年12月31日期间卫生部结核病通报记录进行回顾性研究。
撒哈拉以南非洲的赞比亚。
对赞比亚卫生部年度报告中的结核病病例通报数据进行回顾性分析。
过去37年的年度结核病病例通报率及变化趋势。
1964年至2000年的结核病病例通报数据显示，在过去二十年中增长了12倍，20世纪60年代和70年代在控制结核病方面取得的明显成效在过去二十年中出现逆转。1964年至1984年期间情况稳定（病例通报率保持在每10万人口约100例），自20世纪80年代中期以来呈指数级增长。新结核病病例的绝对数量从1985年的8246例（124/10万）增加到1996年的38863例（409/10万）和2000年的52000例（512/10万）。与邻国（津巴布韦、马拉维和坦桑尼亚）过去二十年的病例通报率比较表明，赞比亚是该地区病例通报率最高的国家之一。
与非洲许多国家一样，赞比亚正处于严重的结核病流行之中，且没有减弱的迹象。这种增长很可能是由于艾滋病毒/艾滋病流行的影响以及随后结核病服务的崩溃。捐助方和政府应共同努力，对结核病控制的长期计划进行适当投资。
