South African Tuberculosis Vaccine Initiative, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Desmond Tutu HIV Center, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
PLoS One. 2020 Jul 1;15(7):e0235206. doi: 10.1371/journal.pone.0235206. eCollection 2020.
Adolescents in the Western Cape Province of South Africa had high force of Mycobacterium tuberculosis (MTB) infection (14% per annum) and high TB incidence (710 per 100,000 person-years) in 2005. We describe subsequent temporal changes in adolescent TB disease notification rates for the decade 2005-2015.
We conducted an analysis of patient-level adolescent (age 10-19 years) TB disease data, obtained from an electronic TB register in the Breede Valley sub-district, Western Cape Province, South Africa, for 2005-2015. Numerators were annual TB notifications (HIV-related and HIV-unrelated); denominators were mid-year population estimates. Period averages of TB rates were obtained using time series modeling. Temporal trends in TB rates were explored using the Mann-Kendall test.
The average adolescent TB disease notification rate was 477 per 100,000 for all TB patients (all-TB) and 361 per 100,000 for microbiologically-confirmed patients. The adolescent all-TB rate declined by 45% from 662 to 361 per 100,000 and the microbiologically-confirmed TB rate by 38% from 492 to 305 per 100,000 between 2005-2015, driven mainly by rapid decreases for the period 2005-2009. There was a statistically significant negative temporal trend in both all-TB (per 100,000) (declined by 48%; from 662 to 343; p = 0·028) and microbiologically confirmed TB (per 100,000) (declined by 49%; from 492 to 252; p = 0·027) for 2005-2009, which was not observed for the period 2009-2015 (rose 5%; from 343 to 361; p = 0·764 and rose 21%; from 252 to 305; p = 1·000, respectively).
We observed an encouraging fall in adolescent TB disease rates between 2005-2009 with a subsequent plateau during 2010-2015, suggesting that additional interventions are needed to sustain initial advances in TB control.
2005 年，南非西开普省的青少年结核分枝杆菌（MTB）感染率（14%/年）和结核病发病率（710/10 万人年）较高。我们描述了 2005-2015 年这十年间青少年结核病发病通知率的后续时间变化。
我们对来自南非西开普省布雷德谷分区电子结核病登记处的 2005-2015 年青少年（10-19 岁）结核病发病数据进行了分析。分子为每年结核病通知数（与 HIV 相关和非 HIV 相关）；分母为年中人口估计数。使用时间序列模型获得结核病率的时期平均值。使用曼肯德尔检验探讨结核病率的时间趋势。
所有结核病患者（所有结核病）的青少年结核病发病通知率平均为 477/10 万人，微生物学确诊患者的发病通知率平均为 361/10 万人。2005-2015 年间，青少年所有结核病发病率从 662 降至 361/10 万人，下降了 45%，微生物学确诊结核病发病率从 492 降至 305/10 万人，下降了 38%，主要是由于 2005-2009 年间迅速下降。所有结核病（每 10 万人）（下降 48%；从 662 降至 343；p=0.028）和微生物学确诊结核病（每 10 万人）（下降 49%；从 492 降至 252；p=0.027）的时间趋势均具有统计学意义的负相关，而 2009-2015 年间则没有观察到这种趋势（从 343 增加至 361；p=0.764 和从 252 增加至 305；p=1.000）。
我们观察到 2005-2009 年间青少年结核病发病率下降令人鼓舞，随后在 2010-2015 年间出现平台期，这表明需要采取额外的干预措施来维持结核病控制的初步进展。
