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到2020年实现消除麻风病：对阿根廷东北部科连特斯省麻风病流行病学指标的预测，该省是消除麻风病的先驱省份。

Towards leprosy elimination by 2020: forecasts of epidemiological indicators of leprosy in Corrientes, a province of northeastern Argentina that is a pioneer in leprosy elimination.

作者信息

Odriozola Elisa Petri de, Quintana Ana María, González Victor, Pasetto Roque Antonio, Utgés María Eugenia, Bruzzone Octavio Augusto, Arnaiz María Rosa

机构信息

Programa Provincial para el Control de Leishmaniasis y Lepra, Corrientes, Argentina.

Programa Nacional para el Control de Tuberculosis y Lepra, Argentina.

出版信息

Mem Inst Oswaldo Cruz. 2017 Jun;112(6):419-427. doi: 10.1590/0074-02760160490.

DOI:10.1590/0074-02760160490
PMID:28591402
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5446231/
Abstract

BACKGROUND

Corrientes, a province of northeastern Argentina with endemic leprosy, has improved its epidemiological indicators, however, a study of the dynamics over time is lacking.

OBJECTIVES

We analysed data of 1308 leprosy patients between 1991 to 2014, and the forecast for 2020.

METHODS

Descriptive statistics and stepwise Bayesian model selection were performed. Forecasts were made using the median of 100,000 projections using the parameters calculated via Monte Carlo methods.

RESULTS

We found a decreasing number of new leprosy cases (-2.04 cases/year); this decrease is expected to continue by an estimated 20.28 +/- 10.00 cases by 2020, evidenced by a sustained decline in detection rate (from 11 to 2.9/100,000 inhabitants). Age groups that were most affected were 15-44 (40.13%) and 45-64 (38.83%) year olds. Multibacillary forms (MB) predominated (70.35%) and while gradually declining, between 10 and 30% developed disability grade 2 (DG2) (0.175 (0.110 - 0.337) DG2/MB cases), with a time delay between 0 to 15 years (median = 0). The proportion of MB clinic forms and DG2 increased and will continuously increase in the short term (0.036 +/- 0.018 logit (MB/total of cases).

MAIN CONCLUSIONS

Corrientes is on the way to eliminating leprosy by 2020, however the increased proportion of MB clinical forms and DG2 signals a warning for disease control efforts.

摘要

背景

科连特斯省位于阿根廷东北部，是麻风病的地方性流行区，其流行病学指标已有改善，但仍缺乏对时间动态变化的研究。

目的

我们分析了1991年至2014年间1308例麻风病患者的数据，并对2020年进行了预测。

方法

进行描述性统计和逐步贝叶斯模型选择。使用通过蒙特卡罗方法计算的参数，对100,000次预测的中位数进行预测。

结果

我们发现新麻风病病例数呈下降趋势（每年减少2.04例）；预计到2020年，这一减少趋势将持续，预计减少20.28±10.00例，检测率持续下降（从每10万居民11例降至2.9例）证明了这一点。受影响最大的年龄组是15 - 44岁（40.13%）和45 - 64岁（38.83%）。多菌型（MB）占主导（70.35%），虽然逐渐下降，但10%至30%的患者出现2级残疾（DG2）（0.175（0.110 - 0.337）DG2/MB病例），时间延迟在0至15年之间（中位数 = 0）。MB临床型和DG2的比例增加，且在短期内将持续增加（0.036±0.018逻辑值（MB/病例总数））。

主要结论

科连特斯省有望在2020年消除麻风病，但MB临床型和DG2比例的增加对疾病控制工作发出了警示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/ccf014df8e68/0074-0276-mioc-112-6-0419-gf09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/ca71e5b2cb14/0074-0276-mioc-112-6-0419-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/38e9a083118e/0074-0276-mioc-112-6-0419-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/f7ce18a86ca9/0074-0276-mioc-112-6-0419-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/de8e988fac1d/0074-0276-mioc-112-6-0419-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/308640c0e017/0074-0276-mioc-112-6-0419-gf05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/94ab37eaccc0/0074-0276-mioc-112-6-0419-gf06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/1a6f5a02cf6f/0074-0276-mioc-112-6-0419-gf07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/126273128b6f/0074-0276-mioc-112-6-0419-gf08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/ccf014df8e68/0074-0276-mioc-112-6-0419-gf09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/ca71e5b2cb14/0074-0276-mioc-112-6-0419-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/38e9a083118e/0074-0276-mioc-112-6-0419-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/f7ce18a86ca9/0074-0276-mioc-112-6-0419-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/de8e988fac1d/0074-0276-mioc-112-6-0419-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/308640c0e017/0074-0276-mioc-112-6-0419-gf05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/94ab37eaccc0/0074-0276-mioc-112-6-0419-gf06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/1a6f5a02cf6f/0074-0276-mioc-112-6-0419-gf07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/126273128b6f/0074-0276-mioc-112-6-0419-gf08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93db/5446231/ccf014df8e68/0074-0276-mioc-112-6-0419-gf09.jpg

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