MMWR Morb Mortal Wkly Rep. 2021 Mar 26;70(12):427-430. doi: 10.15585/mmwr.mm7012a4.
Although tuberculosis (TB) is curable and preventable, in 2019, TB remained the leading cause of death from a single infectious agent worldwide and the leading cause of death among persons living with HIV infection (1). The World Health Organization's (WHO's) End TB Strategy set ambitious targets for 2020, including a 20% reduction in TB incidence and a 35% reduction in the number of TB deaths compared with 2015, as well as zero TB-affected households facing catastrophic costs (defined as costs exceeding 20% of annual household income) (2). In addition, during the 2018 United Nations High-Level Meeting on TB (UNHLM-TB), all member states committed to setting 2018-2022 targets that included provision of TB treatment to 40 million persons and TB preventive treatment (TPT) to 30 million persons, including 6 million persons living with HIV infection and 24 million household contacts of patients with confirmed TB (4 million aged <5 years and 20 million aged ≥5 years) (3,4). Annual data reported to WHO by 215 countries and territories, supplemented by surveys assessing TB prevalence and patient costs in some countries, were used to estimate TB incidence, the number of persons accessing TB curative and preventive treatment, and the percentage of TB-affected households facing catastrophic costs (1). Globally, TB illness developed in an estimated 10 million persons in 2019, representing a decline in incidence of 2.3% from 2018 and 9% since 2015. An estimated 1.4 million TB-related deaths occurred, a decline of 7% from 2018 and 14% since 2015. Although progress has been made, the world is not on track to achieve the 2020 End TB Strategy incidence and mortality targets (1). Efforts to expand access to TB curative and preventive treatment need to be substantially amplified for UNHLM-TB 2022 targets to be met.
虽然结核病 (TB) 是可治愈和可预防的,但 2019 年,结核病仍然是全球范围内单一传染病导致死亡的主要原因,也是艾滋病毒感染者死亡的主要原因 (1)。世界卫生组织 (WHO) 的《终结结核病战略》为 2020 年设定了宏伟目标,包括结核病发病率降低 20%,结核病死亡人数比 2015 年减少 35%,以及零结核病受灾家庭面临灾难性费用(定义为超过家庭年收入 20%的费用) (2)。此外,在 2018 年联合国结核病问题高级别会议(UNHLM-TB)期间,所有会员国承诺制定 2018-2022 年目标,包括向 4000 万人提供结核病治疗和向 3000 万人提供结核病预防性治疗 (TPT),其中包括 600 万艾滋病毒感染者和 2400 万确诊结核病患者的家庭接触者(400 万年龄 <5 岁和 2000 万年龄≥5 岁) (3,4)。215 个国家和地区向世卫组织报告的年度数据,以及一些国家评估结核病流行率和患者费用的调查数据,用于估计结核病发病率、接受结核病治疗和预防性治疗的人数,以及面临灾难性费用的结核病受灾家庭的比例(1)。全球范围内,2019 年估计有 1000 万人患有结核病,发病率比 2018 年下降 2.3%,比 2015 年下降 9%。估计有 140 万人死于与结核病有关的疾病,比 2018 年下降 7%,比 2015 年下降 14%。尽管取得了进展,但世界尚未走上实现 2020 年《终结结核病战略》发病率和死亡率目标的轨道 (1)。为了实现 UNHLM-TB 2022 年的目标,需要大幅扩大结核病治疗和预防性治疗的覆盖面。