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埃塞俄比亚农村社区结核病的次国家级患病率调查。

Sub-national prevalence survey of tuberculosis in rural communities of Ethiopia.

作者信息

Datiko Daniel G, Guracha Ermias Amsalu, Michael Elias, Asnake Girum, Demisse Meaza, Theobald Sally, Tulloch Olivia, Yassin Mohammed A, Cuevas L E

机构信息

REACH ETHIOPIA, Box 303, Hawassa, Ethiopia.

Liverpool School of Tropical Medicine, Pembroke Place L5 3QA, Liverpool, UK.

出版信息

BMC Public Health. 2019 Mar 12;19(1):295. doi: 10.1186/s12889-019-6620-9.

Abstract

BACKGROUND

Tuberculosis is a major public health problem with varying prevalence in different settings. National prevalence surveys provide evidence for planning and decision making. However, they lack the capacity to estimate subnational magnitude that affected the capacity to make selected intervention based on the prevalence. Ethiopia is among high TB burden countries with estimated prevalence of 108 per 100,000 population varying by regions. We aimed to study sub national prevalence of smear-positive TB in rural communities of southern Ethiopia.

METHODS

This cross-sectional study, enrolled community members aged over 14 years who had cough of at least two weeks duration. Two sputum samples were collected and examined by using smear microscopy.

RESULTS

38,304 eligible people were enumerated (10,779 from Hadiya, 10,059 from Gurage and 17,466 from Sidama) and indentified 960 presumptive cases. 16, 14 and 14 smear-positive pulmonary TB cases were identified respectively. The point prevalence of smear-positive TB were 148 per 100,000 population (95% CI: 91-241) in Hadiya, 139 per 100,000 population (95% CI: 83-234) in Gurage and 80/100,000 population (95%CI: 48-135) in Sidama zone. Gurage zone had the highest prevalent to notified cases of seven to one.

CONCLUSIONS

The prevalence of smear positive TB varies by districts and is high in rural southern Ethiopia compared to the estimated national prevalence. More TB patients remain missed and unreached, impacting negatively on health outcomes. TB case finding approaches should be revisited and innovative approaches and tools to identify missing people with TB should be scaled up.

摘要

背景

结核病是一个重大的公共卫生问题,在不同环境中的患病率各不相同。全国患病率调查为规划和决策提供依据。然而,它们缺乏估计国家以下层面规模的能力,这影响了根据患病率进行特定干预的能力。埃塞俄比亚是结核病负担较重的国家之一,估计每10万人口中有108例,且各地区有所不同。我们旨在研究埃塞俄比亚南部农村社区涂片阳性结核病的国家以下层面患病率。

方法

这项横断面研究纳入了年龄在14岁以上、咳嗽至少持续两周的社区成员。采集两份痰标本并使用涂片显微镜检查。

结果

共登记了38304名符合条件的人(哈迪亚地区10779人、古拉格地区10059人、锡达马地区17466人),并确定了960例疑似病例。分别确诊了16例、14例和14例涂片阳性肺结核病例。哈迪亚地区涂片阳性结核病的点患病率为每10万人口148例(95%置信区间:91 - 241),古拉格地区为每10万人口139例(95%置信区间:83 - 234),锡达马地区为80/10万人口(95%置信区间:48 - 135)。古拉格地区的患病率与报告病例数之比最高,为7比1。

结论

涂片阳性结核病的患病率因地区而异,埃塞俄比亚南部农村地区高于全国估计患病率。更多的结核病患者仍未被发现和接触到,对健康结果产生负面影响。应重新审视结核病病例发现方法,并扩大识别隐匿结核病患者的创新方法和工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e193/6417109/bf27aa9c26a1/12889_2019_6620_Fig1_HTML.jpg

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