Khazaei Salman, Ayubi Erfan, Mansournia Mohammad Ali, Rafiemanesh Hossein
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
School of Public Health, Zabol University of Medical Sciences, Zabol, Iran.
J Res Health Sci. 2016 Summer;16(3):141-146.
Investigation of tuberculosis (TB)-specific indices including prevalence of TB, mortality of TB cases excluding HIV, HIV/TB mortality, incidence of TB (all forms), HIV/TB incidence as well as case detection and related trends is a crucial step in evaluation of program performance and strategies success. Besides, estimating the number and time of change points for TB incidence can help to detect effective factors in TB control. Therefore, the current study aimed to determine the trend of aforementioned indices in Iran during a 25 yr period (1990 to 2014).
Data on trend of TB in Iran was extracted from WHO regional office reports during 1990-2014. For determining the trend of TB indices, Annual Percent Changes (APC) and Average Annual Percent Changes (AAPC) was estimated using segmented regression model.
AAPC (95% CI) for HIV/TB mortality and HIV/TB incidence were 11.5 (9.3, 13.6) and 14.8 (13.6, 16.1), respectively, which are sign of increasing trend during the period (P<0.05). Other indices showed significantly decreasing trend (P<0.05), except for case detection rate (P =0.803).
The incidence, prevalence, and death rates of TB had shown a decreasing trend in general population, regarded as a useful indicator of achievements of Millennium Development Goals (MDGs) and effectiveness of interventional programs. Increasing trend of incidence and mortality of TB in HIV infected patients, needs conducting more intervention strategies in health care programs.
对结核病(TB)特异性指标进行调查,包括结核病患病率、排除艾滋病毒的结核病病例死亡率、艾滋病毒/结核病死亡率、结核病(所有类型)发病率、艾滋病毒/结核病发病率以及病例发现情况和相关趋势,是评估项目绩效和策略成功与否的关键步骤。此外,估计结核病发病率的变化点数量和时间有助于发现结核病控制中的有效因素。因此,本研究旨在确定1990年至2014年这25年间伊朗上述指标的趋势。
从世界卫生组织区域办事处1990 - 2014年的报告中提取伊朗结核病趋势数据。为确定结核病指标的趋势,使用分段回归模型估计年度百分比变化(APC)和平均年度百分比变化(AAPC)。
艾滋病毒/结核病死亡率和艾滋病毒/结核病发病率的AAPC(95%置信区间)分别为11.5(9.3,13.6)和14.8(13.6,16.1),这表明在此期间呈上升趋势(P<0.05)。除病例发现率外(P = 0.803),其他指标均呈显著下降趋势(P<0.05)。
结核病的发病率、患病率和死亡率在普通人群中总体呈下降趋势,这被视为千年发展目标(MDGs)取得成效和干预项目有效性的有用指标。艾滋病毒感染患者中结核病发病率和死亡率的上升趋势,需要在医疗保健项目中实施更多干预策略。