Deribew Amare, Deribe Kebede, Dejene Tariku, Tessema Gizachew Assefa, Melaku Yohannes Adama, Lakew Yihune, Amare Azmeraw T, Bekele Tolessa, Abera Semaw F, Dessalegn Muluken, Kumsa Andargachew, Assefa Yibeltal, Kyu Hmwe, Glenn Scott D, Misganaw Awoke, Biadgilign Sibhatu
St. Paul Hospital Millennium Medical College, Ethiopia.
Nutrition International, Ethiopia.
Ethiop J Health Sci. 2018 Sep;28(5):519-528. doi: 10.4314/ejhs.v28i5.2.
The burden of Tuberculosis (TB) has not been comprehensively evaluated over the last 25 years in Ethiopia. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk Factors (GBD) data to analyze the incidence, prevalence and mortality rates of tuberculosis (TB) in Ethiopia over the last 26 years.
The GBD 2016 is a mathematical modeling using different data source for Ethiopia such as verbal autopsy (VA), prevalence surveys and annual case notifications. Age and sex specific causes of death for TB were estimated using the Cause of Death Ensemble Modeling (CODEm). We used the available data such as annual notifications and prevalence surveys as an input to estimate incidence and prevalence rates respectively using DisMod-MR 2.1, a Bayesian meta-regression tool.
In 2016, we estimated 219,186 (95%UI: 182,977-265,292) new, 151,602 (95% UI: 126,054-180,976) prevalent TB cases and 48,910(95% UI: 40,310-58,195) TB deaths. The age-standardized TB incidence rate decreased from 201.6/100,000 to 88.5/100,000 (with a total decline of 56%) between 1990 to 2016. Similarly, the age-standardized TB mortality rate declined from 393.8/100,000 to 100/100,000 between 1990 and 2016(with a total decline of 75%).
Ethiopia has achieved the 50% reduction of most of the Millennium Development Goals (MDGs) targets related to TB. However, the decline of TB incidence and prevalence rates has been comparatively slow. The country should strengthen the TB case detection and treatment programs at community level to achieve its targets during the Sustainable Development Program (SDGs)-era.
过去25年中,埃塞俄比亚尚未对结核病负担进行全面评估。在本研究中,我们使用2016年全球疾病、伤害及风险因素负担(GBD)数据,分析过去26年埃塞俄比亚结核病的发病率、患病率和死亡率。
GBD 2016是一种数学模型,使用了埃塞俄比亚不同的数据源,如口头尸检(VA)、患病率调查和年度病例通报。使用死因综合模型(CODEm)估计结核病的年龄和性别特异性死因。我们分别使用贝叶斯元回归工具DisMod-MR 2.1,将年度通报和患病率调查等可用数据作为输入,来估计发病率和患病率。
2016年,我们估计有219,186例(95%不确定区间:182,977 - 265,292)新发病例、151,602例(95%不确定区间:126,054 - 180,976)现患结核病病例以及48,910例(95%不确定区间:40,310 - 58,195)结核病死亡病例。1990年至2016年间,年龄标准化结核病发病率从201.6/10万降至88.5/10万(总体下降56%)。同样,1990年至2016年间,年龄标准化结核病死亡率从393.8/10万降至100/10万(总体下降75%)。
埃塞俄比亚已实现与结核病相关的大多数千年发展目标(MDGs)指标降低50%。然而,结核病发病率和患病率的下降相对缓慢。该国应在社区层面加强结核病病例发现和治疗项目,以在可持续发展计划(SDGs)时代实现其目标。