World Health Organization Regional Office for the Western Pacific, Manila, Philippines.
World Health Organization, Geneva, Switzerland.
Western Pac Surveill Response J. 2023 Feb 22;14(1):1-12. doi: 10.5365/wpsar.2023.14.1.996. eCollection 2023 Jan-Mar.
Tuberculosis (TB) is one of the most important infectious diseases with an estimated 9.9 million people falling ill globally in 2020. We describe the epidemiology of TB in the Pacific island countries and areas (PICs) to inform potential priority actions to implement the .
A descriptive analysis was conducted using annual TB surveillance data submitted by national TB programmes to the World Health Organization (WHO) and TB burden estimates (incidence rates and number of deaths) generated by WHO for the PICs, for the period 2000-2020. We also analysed TB case numbers, multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB), recent risk factor indicators and treatment outcomes.
The estimated TB incidence rate in the PICs increased between 2000 and 2020 from 62 to 69 per 100 000 population, with an 8% reduction observed since 2015. TB cases increased by 29% during 2000-2020, with 1746 cases in 2020 and a high proportion in children (19%). Bacteriological diagnosis was used for 58% of total TB cases, although some countries reported clinical diagnoses in over 60% of cases. From 2015 to 2019, 52 MDR/RR-TB cases were reported and there were 94 TB/HIV coinfected cases in 2015-2020. Treatment success was 74% in 2019 due to 18% of cases being unevaluated. In 2020, the estimated proportion of TB cases attributable to smoking, malnutrition, alcohol abuse and diabetes was 17%, 16%, 11% and 9%, respectively.
There was an increasing trend in TB cases, estimated incidence and deaths between 2000 and 2020. Laboratory services were scaled up in some PICs and case-finding activities greatly contributed to the detection of cases. To end the incidence of TB, continued efforts on case finding, contact investigation and scaling up TB preventive treatment should be prioritized. At the same time, collaboration with other sectors for risk factor management and decentralized management need to be considered.
结核病（TB）是最重要的传染病之一，据估计，全球 2020 年有 990 万人患病。我们描述了太平洋岛屿国家和地区（PICs）的结核病流行病学情况，以便为实施. 提供潜在的优先行动。
利用国家结核病规划向世界卫生组织（WHO）提交的年度结核病监测数据和 WHO 为 PICs 生成的结核病负担估计（发病率和死亡人数），对 2000-2020 年期间的结核病进行描述性分析。我们还分析了结核病病例数、耐多药/利福平耐药结核病（MDR/RR-TB）、近期风险因素指标和治疗结果。
PICs 的估计结核病发病率在 2000 年至 2020 年间从 62 例/10 万人口增加到 69 例/10 万人口，自 2015 年以来下降了 8%。结核病病例在 2000-2020 年间增加了 29%，2020 年有 1746 例病例，其中儿童比例较高（19%）。虽然一些国家报告的临床诊断病例超过 60%，但有 58%的结核病总病例采用了细菌学诊断。2015 年至 2019 年期间，报告了 52 例耐多药/利福平耐药结核病病例，2015 年至 2020 年期间有 94 例结核病/艾滋病毒合并感染病例。由于 18%的病例未进行评估，2019 年的治疗成功率为 74%。2020 年，吸烟、营养不良、酗酒和糖尿病导致的结核病病例比例分别为 17%、16%、11%和 9%。
2000 年至 2020 年间，结核病病例、估计发病率和死亡人数呈上升趋势。一些 PICs 扩大了实验室服务，病例发现活动极大地促进了病例的发现。为了终结结核病的发病率，应优先考虑继续开展病例发现、接触者调查和扩大结核病预防性治疗工作。同时，需要考虑与其他部门合作，进行风险因素管理和权力下放管理。
