Tam Greta, Lai Shuk Wun
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
SAGE Open Med. 2019 May 19;7:2050312119851331. doi: 10.1177/2050312119851331. eCollection 2019.
Tuberculosis remains the top 10 causes of death worldwide in 2015, with the largest number of new tuberculosis cases occurring in Asia. Singapore, a high-income Asian country, still has an intermediate tuberculosis burden. This study is to determine Singapore's tuberculosis policy with regard to achieving tuberculosis elimination goals. This is a case study of tuberculosis elimination policy in Singapore. Data were collected by policy review and literature review. Policy documents and reports were gathered from the websites of the Ministry of Health and the World Health Organization for policy review. The literature review was carried out through PubMed and Google Scholar to identify articles on epidemiology, treatment, and prevention of tuberculosis in Singapore. Data analysis of policy reports revealed that despite the overall downwards trend in the tuberculosis incidence rates between 2000 and 2015, the tuberculosis incidence rates reversed in 2008. Singapore tuberculosis policies are mostly consistent with the World Health Organization Stop TB Strategy, although over half of the performance indicators were not achieved by 2015. After screening 1014 articles, 18 studies were included in the literature review. The rapidly ageing population, great population mobility, and continuous community transmission were found to be major obstacles to achieving Millennium Development Goals in Singapore. Singapore is lagging in achieving the targets. Scaling up the existing tuberculosis programme to accelerate the tuberculosis decline is required to meet Sustainable Development Goals 2030. Unlike other high-income countries with an intermediate tuberculosis burden in Asia, Singapore has increasing tuberculosis incidence rates. While other countries face the burden of an ageing population, Singapore faces an additional burden of an influx of migrants from high-incidence countries. Singapore will need to control tuberculosis in both these demographic groups to reverse the increasing incidence trend.
2015年，结核病仍是全球十大死因之一，新增结核病病例数最多的地区是亚洲。新加坡作为亚洲的高收入国家，结核病负担仍处于中等水平。本研究旨在确定新加坡在实现结核病消除目标方面的结核病政策。这是一项关于新加坡结核病消除政策的案例研究。数据通过政策审查和文献综述收集。政策文件和报告从新加坡卫生部和世界卫生组织的网站收集以进行政策审查。文献综述通过PubMed和谷歌学术进行，以查找有关新加坡结核病流行病学、治疗和预防的文章。政策报告的数据分析显示，尽管2000年至2015年期间结核病发病率总体呈下降趋势，但在2008年出现了逆转。新加坡的结核病政策大多与世界卫生组织的《终止结核病战略》一致，尽管到2015年超过一半的绩效指标未实现。在筛选了1014篇文章后，18项研究被纳入文献综述。研究发现，人口快速老龄化、人口流动性大以及社区传播持续存在是新加坡实现千年发展目标的主要障碍。新加坡在实现目标方面滞后。需要扩大现有的结核病防治计划以加速结核病发病率下降，从而实现2030年可持续发展目标。与亚洲其他结核病负担中等的高收入国家不同，新加坡的结核病发病率在上升。其他国家面临人口老龄化的负担，而新加坡除了这一负担外，还面临来自高发病率国家移民涌入的额外负担。新加坡需要在这两个人口群体中控制结核病，以扭转发病率上升的趋势。
