Bloom B R, Murray C J
Howard Hughes Medical Institute, Albert Einstein College of Medicine, Bronx, NY 10461.
Science. 1992 Aug 21;257(5073):1055-64. doi: 10.1126/science.257.5073.1055.
Tuberculosis remains the leading cause of death in the world from a single infectious disease, although there is little knowledge of the mechanisms of its pathogenesis and protection from it. After a century of decline in the United States, tuberculosis is increasing, and strains resistant to multiple antibiotics have emerged. This excess of cases is attributable to changes in the social structure in cities, the human immunodeficiency virus epidemic, and a failure in certain major cities to improve public treatment programs. The economic costs of not adequately addressing the problem of tuberculosis in this country are estimated from an epidemiological model.
结核病仍然是全球单一传染病致死的首要原因,尽管人们对其发病机制和预防机制知之甚少。在美国,结核病发病率经过一个世纪的下降后正在上升,并且出现了对多种抗生素耐药的菌株。病例增多归因于城市社会结构的变化、人类免疫缺陷病毒的流行以及某些大城市未能改进公共治疗方案。通过一种流行病学模型估算了美国未能充分解决结核病问题所产生的经济成本。