Heng B H, Tan K K
Epidemiology Department, Ministry of Health, Singapore.
Bull Int Union Tuberc Lung Dis. 1991 Jun-Sep;66(2-3):125-8.
Tuberculosis (TB) mortality for the period 1955-1959 to 1985-1989 declined 87% from 72 to 9 per 100,000 in males, and 90% from 31 to 3 per 100,000 in females. The mean annual rate of decline of mortality was 6.8%. Older persons had a lower 4.2-5.2% decline annually compared to 14.1-16.0% in the 0-4 year age group. The incidence of TB declined 80% from 438 to 88 per 100,000 in males, and 71% from 152 to 43 per 100,000 in females over the period 1960-64 to 1985-89. The mean annual rate of decline in incidence was 5.9%. The lowest decline was observed in the children below 15 years (2.8-3.2%) and elderly persons 65 years and above (2.3-5.5%). Birth cohorts of 1945-49 and earlier had progressively higher mortality risks, but declining morbidity risks as they advanced with age. Singapore has overcome the early phase of the TB epidemic as evidenced by its relatively low rates among children and females and the low rates of extra-pulmonary TB and meningitis. The high incidence rates in old people are the residue of even higher rates experienced by this cohort of persons who experienced higher risks of infection in their early lives. At the prevailing rates of decline under the present conditions and control measures, TB will not be eliminated in Singapore over the next 50 years.
1955 - 1959年至1985 - 1989年期间，男性结核病死亡率从每10万人72例降至9例，降幅为87%；女性从每10万人31例降至3例，降幅为90%。死亡率的年均下降率为6.8%。老年人的死亡率年均下降率较低，为4.2 - 5.2%，而0 - 4岁年龄组的年均下降率为14.1 - 16.0%。1960 - 1964年至1985 - 1989年期间，男性结核病发病率从每10万人438例降至88例，降幅为80%；女性从每10万人152例降至43例，降幅为71%。发病率的年均下降率为5.9%。15岁以下儿童（2.8 - 3.2%）和65岁及以上老年人（2.3 - 5.5%）的发病率下降幅度最小。1945 - 1949年及更早出生队列的死亡风险逐渐升高，但随着年龄增长发病风险下降。新加坡已度过结核病流行的早期阶段，这体现在儿童和女性中的发病率相对较低，以及肺外结核和脑膜炎发病率较低。老年人的高发病率是该队列人群早期感染风险较高时更高发病率的遗留问题。按照当前条件和控制措施下的普遍下降率，未来50年新加坡无法消除结核病。
