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[2005年至2018年智利首都大区结核病的社会流行病学特征及演变]

[Socio-epidemiological caracterization and evolution of tuberculosis in the Metropolitan Region of Chile, 2005 to 2018].

作者信息

Olmos Claudio, Stuardo Valeria, Ramonda Paulina, Peña Carlos

机构信息

Departamento de Pediatría, Ginecología y Medicina Preventiva, Universidad Autónoma de Barcelona, Barcelona, España.

Escuela de Salud Pública, Universidad de Chile, Santiago, Chile.

出版信息

Rev Chilena Infectol. 2020 Jun;37(3):237-243. doi: 10.4067/s0716-10182020000300237.

Abstract

BACKGROUND

The Chilean Program for the Control and Elimination of Tuberculosis (PROCET) has reduced mortality from this disease by 78% between 2004 and 2013. However, after decades of successful results, starting in 2000 there was a slowdown in the reduction of incidence and since 2014, an increase in it.

AIM

To describe the socio-epidemiological evolution of tuberculosis (TB) cases treated at health clinics in the Metropolitan Region (MR) of Chile from 2005 to 2018, stratifying by country of origin.

METHODS

Cross-sectional study with ecological components, including analyses of age, sex, TB localization, bacteriological confirmation of diagnosis, co-infection with HIV, incarceration, country of origin, and effectiveness of tuberculosis treatment.

RESULTS

A total of 7,507 TB cases were recorded during the study period; 75.1% of cases were pulmonary tuberculosis, and 65.4% were bacteriologically confirmed. Overall, 19.0% of cases involved persons born outside of Chile, with the proportion of cases in foreign-born persons increasing over the past 6 years. Incidence decreased during the first half of the study period but then began to increase after 2012, moving the country away from the threshold of elimination. A total of 74.3% of cases were treated successfully, and 13.4% expired.

CONCLUSION

In recent years, TB incidence has increased in the MR of Chile, possibly attributable to growing populations of vulnerable groups such as immigrants. This finding suggests an urgent need to implement and reinforce strategies such as education, an active screening model and more efficient contact tracing to prevent the spread of TB.

摘要

背景

智利结核病控制与消除计划(PROCET)在2004年至2013年间已将该疾病的死亡率降低了78%。然而,在取得数十年的成功成果之后,自2000年起发病率下降速度放缓,自2014年起发病率开始上升。

目的

描述2005年至2018年智利首都大区(MR)卫生诊所治疗的结核病(TB)病例的社会流行病学演变情况,并按原籍国进行分层。

方法

采用包含生态成分的横断面研究,分析年龄、性别、结核病发病部位、诊断的细菌学确认、艾滋病毒合并感染、监禁情况、原籍国以及结核病治疗效果。

结果

研究期间共记录了7507例结核病病例;75.1%的病例为肺结核,65.4%的病例经细菌学确诊。总体而言,19.0%的病例涉及出生在智利境外的人,过去6年外国出生者的病例比例有所增加。发病率在研究期的前半段下降,但在2012年后开始上升,使该国偏离了消除结核病的阈值。共有74.3%的病例得到成功治疗,13.4%的病例死亡。

结论

近年来,智利首都大区的结核病发病率有所上升,这可能归因于移民等弱势群体数量的增加。这一发现表明迫切需要实施和加强教育、积极筛查模式及更有效的接触者追踪等策略,以防止结核病传播。

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