Okhovat-Isfahani Batoul, Bitaraf Saeid, Mansournia Mohammad Ali, Doosti-Irani Amin
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2019 May 22;33:45. doi: 10.34171/mjiri.33.45. eCollection 2019.
Tuberculosis (TB) is one of the ten leading causes of death, especially in developing countries. We aimed to assess the inequality in the incidence and prevalence of TB and TB/HIV based on the human development index (HDI) globally. In this ecological study, the data on the incidence and prevalence of TB, HIV, and TB/HIV co-infection in 168 countries were obtained from the World Health Organization (WHO). The HDI of these countries in 2000, 2005, 2010, and 2015 was also obtained from the United Nations Development Program (UNDP). The concentration index was used to assess the inequality of the incidence and prevalence of TB and TB/HIV based on the HDI globally. The concentration index for the incidence of TB according to the HDI was -0.32 (95% CI: -0.46, -0.17), -0.36 (95% CI: -0.49, -0.23), -0.37 (95% CI: -0.52, -0.22), and -0.36 (-0.52, -0.21) in 2000, 2005, 2010, and 2015, respectively. The same pattern was observed for the incidence and prevalence of TB/HIV. The results showed that TB and TB/HIV mainly concentrated in countries with a lower HDI. According to the results of this study, the incidence of TB and TB/HIV and the prevalence of TB/HIV concentrated in the countries with a lower HDI. In addition, inequality in TB and HIV based on the HDI did not change from 2000 to 2015. Therefore, it seems that public health programs, especially in low-income countries, should be revised and the World Health Organization and the United Nations should provide more technical and financial help for these countries.
结核病是十大主要死因之一，在发展中国家尤为如此。我们旨在基于全球人类发展指数（HDI）评估结核病及结核病/艾滋病毒合并感染的发病率和患病率的不平等情况。在这项生态学研究中，168个国家的结核病、艾滋病毒及结核病/艾滋病毒合并感染的发病率和患病率数据来自世界卫生组织（WHO）。这些国家在2000年、2005年、2010年和2015年的人类发展指数也来自联合国开发计划署（UNDP）。浓度指数用于基于全球人类发展指数评估结核病及结核病/艾滋病毒合并感染的发病率和患病率的不平等情况。2000年、2005年、2010年和2015年，根据人类发展指数得出的结核病发病率浓度指数分别为-0.32（95%置信区间：-0.46，-0.17）、-0.36（95%置信区间：-0.49，-0.23）、-0.37（95%置信区间：-0.52，-0.22）和-0.36（-0.52，-0.21）。结核病/艾滋病毒的发病率和患病率也呈现相同模式。结果表明，结核病及结核病/艾滋病毒主要集中在人类发展指数较低的国家。根据本研究结果，结核病及结核病/艾滋病毒的发病率以及结核病/艾滋病毒的患病率集中在人类发展指数较低的国家。此外，基于人类发展指数的结核病和艾滋病毒不平等情况在2000年至2015年期间没有变化。因此，似乎公共卫生项目，尤其是在低收入国家，应该进行修订，世界卫生组织和联合国应该为这些国家提供更多技术和资金援助。
