Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
Extra-pulmonary Research Unity, Hedi Chaker University Hospital, Sfax, Tunisia.
PLoS One. 2019 Jul 24;14(7):e0212853. doi: 10.1371/journal.pone.0212853. eCollection 2019.
Tuberculosis (TB) is a public health problem worldwide. Characterizing its trends over time is a useful tool for decision-makers to assess the efficiency of TB control programs. We aimed to give an update on the current chronological trends of TB in Southern Tunisia from 1995 to 2016 and to estimate future trajectories of TB epidemic by 2030.
We retrospectively collected data of all notified TB new cases by the Center of Tuberculosis Control between 1995 and 2016 in South of Tunisia. Joinpoint Regression Analysis was performed to analyze chronological trends and annual percentage changes (APC) were estimated.
In the past 22 years, a total of 2771 cases of TB were notified in Southern Tunisia. The annual incidence rate of TB was 13.91/100,000 population/year. There was a rise in all forms of TB incidence (APC = 1.63) and in extrapulmonary tuberculosis (EPTB) (APC = 2.04). The incidence of TB increased in children and adult females between 1995 and 2016 (APC = 4.48 and 2.37, respectively). The annual number of TB declined in urban districts between 2004 and 2016 (APC = -2.85). Lymph node TB cases increased (APC = 4.58), while annual number of urogenital TB decreased between 1995 and 2016 (APC = -3.38). Projected incidence rates would increase to 18.13 and 11.8/100,000 population in 2030 for global TB and EPTB, respectively.
Our study highlighted a rise in all forms of TB and among high-risk groups, notably children, females and lymph node TB patients in the last two decades and up to the next one.
结核病（TB）是全球公共卫生问题。随着时间的推移，对其趋势进行描述是决策者评估结核病控制计划效率的有用工具。我们旨在更新突尼斯南部从 1995 年到 2016 年结核病的当前时间趋势，并估计到 2030 年结核病流行的未来轨迹。
我们回顾性地收集了突尼斯南部结核病控制中心在 1995 年至 2016 年期间报告的所有新结核病例的数据。使用 Joinpoint 回归分析来分析时间趋势，并估计年度百分比变化（APC）。
在过去的 22 年中，突尼斯南部共报告了 2771 例结核病病例。结核病的年发病率为 13.91/100000 人/年。所有形式的结核病发病率（APC=1.63）和肺外结核病（EPTB）（APC=2.04）均有所上升。1995 年至 2016 年间，儿童和成年女性的结核病发病率均有所增加（APC=4.48 和 2.37）。2004 年至 2016 年，城市地区的结核病年发病数下降（APC=-2.85）。淋巴结结核病病例增加（APC=4.58），而 1995 年至 2016 年间，泌尿生殖系统结核病的年发病数减少（APC=-3.38）。预计到 2030 年，全球结核病和肺外结核病的发病率将分别增加到 18.13 和 11.8/100000 人。
我们的研究表明，在过去二十年中，所有形式的结核病以及高风险群体（尤其是儿童、女性和淋巴结结核病患者）的发病率均有所上升，并且在未来十年中还将继续上升。
