Rastegar Maryam, Nazar Eisa, Nasehi Mahshid, Sharafi Saeed, Fakoor Vahid, Shakeri Mohammad Taghi
Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Infect Dis Model. 2024 May 10;9(3):963-974. doi: 10.1016/j.idm.2024.05.003. eCollection 2024 Sep.
Tuberculosis (TB) is one of the most prevalent infectious diseases in the world, causing major public health problems in developing countries. The rate of TB incidence in Iran was estimated to be 13 per 100,000 in 2021. This study aimed to estimate the reproduction number and serial interval for pulmonary tuberculosis in Iran.
The present national historical cohort study was conducted from March 2018 to March 2022 based on data from the National Tuberculosis and Leprosy Registration Center of Iran's Ministry of Health and Medical Education (MOHME). The study included 30,762 tuberculosis cases and 16,165 new smear-positive pulmonary tuberculosis patients in Iran. We estimated the reproduction number of pulmonary tuberculosis in a Bayesian framework, which can incorporate uncertainty in estimating it. Statistical analyses were accomplished in R software.
The mean age at diagnosis of patients was 52.3 ± 21.2 years, and most patients were in the 35-63 age group (37.1%). Among the data, 9121 (56.4%) cases were males, and 7044 (43.6%) were females. Among patients, 7459 (46.1%) had a delayed diagnosis between 1 and 3 months. Additionally, 3039 (18.8%) cases were non-Iranians, and 2978 (98%) were Afghans. The time-varying reproduction number for pulmonary tuberculosis disease was calculated at an average of 1.06 ± 0.05 (95% Crl 0.96-1.15).
In this study, the incidence and the time-varying reproduction number of pulmonary tuberculosis showed the same pattern. The mean of the time-varying reproduction number indicated that each infected person is causing at least one new infection over time, and the chain of transmission is not being disrupted.
结核病是世界上最普遍的传染病之一，在发展中国家造成了重大的公共卫生问题。2021年，伊朗的结核病发病率估计为每10万人中有13例。本研究旨在估计伊朗肺结核的繁殖数和传播间隔。
本项全国历史性队列研究于2018年3月至2022年3月进行，数据来源于伊朗卫生和医学教育部（MOHME）的国家结核病和麻风病登记中心。该研究纳入了伊朗的30762例结核病病例和16165例新的涂片阳性肺结核患者。我们在贝叶斯框架下估计了肺结核的繁殖数，该框架可以纳入估计过程中的不确定性。统计分析在R软件中完成。
患者的平均诊断年龄为52.3±21.2岁，大多数患者在35-63岁年龄组（37.1%）。在数据中，9121例（56.4%）为男性，7044例（43.6%）为女性。在患者中，7459例（46.1%）的诊断延迟了1至3个月。此外，3039例（18.8%）病例为非伊朗人，其中2978例（98%）为阿富汗人。肺结核病的时变繁殖数经计算平均为1.06±0.05（95%可信区间0.96-1.15）。
在本研究中，肺结核的发病率和时变繁殖数呈现相同的模式。时变繁殖数的平均值表明，随着时间的推移，每个感染者至少会引起一次新的感染，并且传播链没有被中断。
