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利用结核病项目为未来大流行做准备:对新冠肺炎的回顾审视

Leveraging tuberculosis programs for future pandemic preparedness: A retrospective look on COVID-19.

作者信息

Bowen Whitney, Tri Ho, Romero Sebastian, Shaheen Roaa, Kipngetich Victoria, McGowan Nick, Moon Sungho, Bhattacharya Esha, Hecht Robert, Soe-Lin Shan, Collins Chris

机构信息

Jackson School of Global Affairs, Yale University, New Haven, Connecticut, United States of America.

Yale Institute for Global Health, Yale School of Public Health, New Haven, Connecticut, United States of America.

出版信息

PLOS Glob Public Health. 2024 Sep 5;4(9):e0003454. doi: 10.1371/journal.pgph.0003454. eCollection 2024.

DOI:10.1371/journal.pgph.0003454
PMID:39236018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11376540/
Abstract

Worldwide, COVID-19 has decimated healthcare systems and highlighted the pressing need to ensure resilience for future pandemics. Given the almost 30% likelihood of another respiratory disease similar to COVID-19 manifesting in the next 10 years, it is imperative to prioritize pandemic preparedness in the immediate future. To this end, tuberculosis (TB) and its management share many similarities to respiratory disease protection, offering an opportunity to dually strengthen TB programs and protect against future pandemics. Looking at data from the World Health Organization (WHO), Global Fund, Our World in Data, and domestic health ministries, it was hypothesized that countries that had better TB program strength going into the pandemic fared better with COVID-19 than those with poorer TB treatment. It was found that countries that recovered their TB program strength (as measured by TB treatment coverage percentages) to or above pre-pandemic levels fared better in terms of COVID-19 pandemic incidence and death. Case studies helped identify common factors across resilient TB platforms in dually successful COVID-19 and TB countries, including community trust, co-epidemic responses that were able to maintain continuity of care, sustained innovation, comprehensive communication across public and private sectors, and maintenance of donor support for TB programs through the pandemic.

摘要

在全球范围内,新冠疫情重创了医疗系统,并凸显了确保未来应对大流行具备韧性的迫切需求。鉴于未来10年内出现另一种类似于新冠的呼吸道疾病的可能性近30%,当务之急是在近期优先做好大流行防范工作。为此,结核病及其管理与呼吸道疾病防护有许多相似之处,这为同时加强结核病防治项目和防范未来大流行提供了契机。通过研究世界卫生组织(WHO)、全球基金、“我们的数据世界”以及各国卫生部的数据,我们推测,在疫情来袭时结核病防治项目实力较强的国家,在应对新冠疫情方面比结核病治疗水平较差的国家表现更好。研究发现,那些将结核病防治项目实力(以结核病治疗覆盖率衡量)恢复到疫情前水平或以上的国家,在新冠疫情发病率和死亡率方面表现更好。案例研究有助于确定在新冠疫情和结核病防治方面均取得成功的国家中,具备韧性的结核病防治平台所共有的因素,包括社区信任、能够维持医疗连续性的共同疫情应对措施、持续创新、公共部门和私营部门之间的全面沟通,以及在疫情期间维持对结核病防治项目的捐助支持。

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本文引用的文献

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Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria-A mixed methods study.尼日利亚两个城市地区私营卫生部门在新冠疫情第一年期间的结核病服务中断与调整——一项混合方法研究
PLOS Glob Public Health. 2023 Mar 24;3(3):e0001618. doi: 10.1371/journal.pgph.0001618. eCollection 2023.
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The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions.结核病和 COVID-19 大流行的交织:人群层面和患者层面的影响、临床表现和纠正干预措施。
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The scientific response to TB - the other deadly global health emergency.
针对结核病(另一个致命的全球卫生突发事件)的科学应对措施。
Int J Tuberc Lung Dis. 2022 Mar 1;26(3):186-189. doi: 10.5588/ijtld.21.0734.
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Tuberculosis amidst COVID-19 in Pakistan: a massive threat of overlapping crises for the fragile healthcare systems.巴基斯坦的 COVID-19 与结核病:脆弱的医疗体系面临的重叠危机的巨大威胁。
Epidemiol Infect. 2022 Feb 22;150:e41. doi: 10.1017/S0950268822000358.
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Build on HIV investments for future pandemic preparedness.基于对艾滋病的投资,为未来防范大流行病做准备。
BMJ Glob Health. 2021 Dec;6(12). doi: 10.1136/bmjgh-2021-007980.