Ding Cheng, Wang Shuting, Shangguan Yanwan, Feng Xuewen, Guo Wanru, Shi Pei, Ji Zhongkang, Xu Kaijin
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang, People's Republic of China.
Infect Drug Resist. 2020 Jun 9;13:1663-1672. doi: 10.2147/IDR.S249698. eCollection 2020.
Tuberculosis remains a major public health problem globally, especially in undeveloped countries. This study aimed to evaluate and review the long-term epidemic trends of tuberculosis in China.
Data were extracted from the Global Health Data Exchange. Metrics (prevalence, incidence and mortality) and Joinpoint regression were used to identify the epidemic trends.
From 1990 to 2017, decreasing trends in prevalence (average annual percent change, AAPC: -0.5%, 95% CI: -0.6% to -0.5%), incidence (-3.2%, 95% CI: -3.5% to -2.9%), and mortality (-5.7%, 95% CI: -6.2% to -5.3%) of tuberculosis were observed. The incidence and mortality of multidrug-resistant tuberculosis (MDR-TB) decreased with AAPC of -2.3% (-3.1% to -1.4%) and -4.9% (-5.4% to -4.5%), respectively, while the prevalence increased with an AAPC of 1.2% (0.3% to 2.0%). The burden of extensively drug-resistant tuberculosis (XDR-TB) increased with an AAPC of 12.5% (11.9% to 13.2%) in prevalence, 7.6% (6.5% to 8.7%) in incidence, and 4.5% (3.6% to 5.4%) in mortality. The disease burden of tuberculosis increased with age and peaked among those aged over 70.
The epidemic of tuberculosis decreased in China, while the disease burden was still challenging to control. MDR-TB and XDR-TB should be emphasized along with the epidemic. It will certainly be a difficult task to achieve the post-2015 global targets by 2025 and 2035.
结核病仍是全球主要的公共卫生问题，在不发达国家尤为如此。本研究旨在评估和回顾中国结核病的长期流行趋势。
数据取自全球卫生数据交换平台。采用指标（患病率、发病率和死亡率）及Joinpoint回归分析来确定流行趋势。
1990年至2017年，观察到结核病的患病率（平均年变化百分比，AAPC：-0.5%，95%可信区间：-0.6%至-0.5%）、发病率（-3.2%，95%可信区间：-3.5%至-2.9%）和死亡率（-5.7%，95%可信区间：-6.2%至-5.3%）呈下降趋势。耐多药结核病（MDR-TB）的发病率和死亡率分别以-2.3%（-3.1%至-1.4%）和-4.9%（-5.4%至-4.5%）的AAPC下降，而患病率以1.2%（0.3%至2.0%）的AAPC上升。广泛耐药结核病（XDR-TB）的负担在患病率方面以12.5%（11.9%至13.2%）的AAPC增加，发病率方面为7.6%（6.5%至8.7%），死亡率方面为4.5%（3.6%至5.4%）。结核病的疾病负担随年龄增长而增加，在70岁以上人群中达到峰值。
中国结核病的流行有所下降，但疾病负担的控制仍具有挑战性。应在关注疫情的同时，重视耐多药结核病和广泛耐药结核病。要在2025年和2035年实现2015年后的全球目标，无疑是一项艰巨的任务。
