Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, 510515, China.
Department of MICU, Guangdong Women and Children Hospital, Guangzhou, China.
Infect Dis Poverty. 2021 Mar 6;10(1):24. doi: 10.1186/s40249-021-00803-w.
Antituberculosis-drug resistance is an important public health issue, and its epidemiological patterns has dramatically changed in recent decades. This study aimed to estimate the trends of multidrug-resistant tuberculosis (MDR-TB), which can be used to inform health strategies.
Data were collected from the Global Burden of Disease study 2017. The estimated annual percentage changes (EAPCs) were calculated to assess the trends of MDR-TB burden at global, regional, and national level from 1990 to 2017 using the linear regression model.
Globally, the age-standardized rate (ASR) of MDR-TB burden including incidence, prevalence, death and disability-adjusted life years (DALYs) had pronounced increasing trends from 1990 to 1999, with the EAPCs were 17.63 [95% confidence interval (CI): 10.77-24.92], 17.57 (95% CI 11.51-23.95), 21.21 (95% CI 15.96-26.69), and 21.90 (95% CI 16.55-27.50), respectively. Particularly, the largest increasing trends were seen in areas and countries with low and low-middle sociodemographic index (SDI). However, the trends in incidence, prevalence, death and DALYs of MDR-TB decreased globally from 2000 to 2017, with the respective EAPCs were - 1.37 (95% CI - 1.62 to - 1.12), - 1.32 (95% CI - 1.38 to - 1.26), - 3.30 (95% CI - 3.56 to - 3.04) and - 3.32 (95% CI - 3.59 to - 3.06). Decreasing trends of MDR-TB were observed in most regions and countries, particularly that of death and DALYs in Slovenia were - 18.96 (95% CI - 20.82 to - 17.06) and -19.35 (95% CI - 21.10 to - 17.55), respectively. Whereas the pronounced increasing trends of MDR-TB occurred in Papua New Guinea, Singapore, and Australia.
The ASR of MDR-TB showed pronounced decreasing trends from 2000 to 2017. However, the MDR-TB burden remains a substantial challenge to the TB control globally, and requires effective control strategies and healthcare systems.
抗结核药物耐药性是一个重要的公共卫生问题，其流行病学模式在近几十年来发生了显著变化。本研究旨在估计耐多药结核病（MDR-TB）的趋势，这可以为卫生策略提供信息。
数据来自 2017 年全球疾病负担研究。使用线性回归模型，从全球、区域和国家层面评估 1990 年至 2017 年 MDR-TB 负担的趋势，计算估计年变化百分比（EAPC）。
全球范围内，MDR-TB 负担的年龄标准化率（ASR）包括发病率、患病率、死亡率和残疾调整生命年（DALYs），从 1990 年至 1999 年呈明显上升趋势，EAPC 分别为 17.63 [95%置信区间（CI）：10.77-24.92]、17.57（95% CI 11.51-23.95）、21.21（95% CI 15.96-26.69）和 21.90（95% CI 16.55-27.50）。特别是，在社会人口指数（SDI）较低和中下的地区和国家，趋势最为明显。然而，从 2000 年至 2017 年，全球 MDR-TB 的发病率、患病率、死亡率和 DALYs 呈下降趋势，EAPC 分别为-1.37（95% CI-1.62 至-1.12）、-1.32（95% CI-1.38 至-1.26）、-3.30（95% CI-3.56 至-3.04）和-3.32（95% CI-3.59 至-3.06）。大多数地区和国家的 MDR-TB 都呈现出下降趋势，特别是斯洛文尼亚的死亡率和 DALYs 下降趋势最为明显，分别为-18.96（95% CI-20.82 至-17.06）和-19.35（95% CI-21.10 至-17.55）。然而，巴布亚新几内亚、新加坡和澳大利亚的 MDR-TB 发病率呈显著上升趋势。
从 2000 年至 2017 年，MDR-TB 的 ASR 呈显著下降趋势。然而，MDR-TB 负担仍然是全球结核病控制的一个重大挑战，需要有效的控制策略和医疗保健系统。
Zotero 插件
