Division of Global Public Health, School of Medicine, University of California at San Diego, San Diego, CA 92093-0507, USA.
Ann Epidemiol. 2011 Oct;21(10):791-5. doi: 10.1016/j.annepidem.2011.07.002. Epub 2011 Aug 5.
To describe long-term trends in tuberculosis (TB) mortality and to compare trends estimated from two different sources of public health surveillance data.
Trends and changes in trend were estimated by joinpoint regression. Comparisons between data sets were made by fitting a Poisson regression model.
Since 1900, TB mortality rates estimated from death certificates have declined steeply, except for a period of no change in the 1980s. This decade had long-term consequences resulting in more TB deaths in later years than would have occurred had there been no flattening of the trend. Recent trends in TB mortality estimated from National Tuberculosis Surveillance System (NTSS) data, which record all-cause mortality, differed from trends based on death certificates. In particular, NTSS data showed TB mortality rates flattening since 2002.
Estimates of trends in TB mortality vary by data source, and therefore interpretation of the success of control efforts will depend on the surveillance data set used. The data sets may be subject to different biases that vary with time. One data set showed a sustained improvement in the control of TB since the early 1990s whereas the other indicated that the rate of TB mortality was no longer declining.
描述结核病（TB）死亡率的长期趋势，并比较两种不同公共卫生监测数据源估计的趋势。
采用 Joinpoint 回归估计趋势和趋势变化。通过拟合泊松回归模型比较数据集。
自 1900 年以来，除了 20 世纪 80 年代的一段不变期外，从死亡证明中估计的结核病死亡率急剧下降。这十年造成了长期后果，导致后来的结核病死亡人数比没有减缓趋势的情况下多。从记录所有原因死亡率的国家结核病监测系统（NTSS）数据中估计的最近结核病死亡率趋势与基于死亡证明的趋势不同。特别是，NTSS 数据显示，自 2002 年以来，结核病死亡率趋于平稳。
结核病死亡率趋势的估计因数据源而异，因此，对控制工作成功的解释将取决于使用的监测数据集。数据集可能受到随时间变化的不同偏差的影响。一个数据集显示自 20 世纪 90 年代初以来结核病控制持续改善，而另一个数据集则表明结核病死亡率不再下降。
