Horsburgh C R, E Jenkins Helen, Martinez L, White L F
Department of Epidemiology, Boston University School of Public Health Boston MA USA.
Department of Global Health, Boston University School of Public Health Boston MA USA.
IJTLD Open. 2025 Jun 13;2(6):352-358. doi: 10.5588/ijtldopen.25.0014. eCollection 2025 Jun.
The proportion of persons with infectious TB that need to be cured to reduce prevalence is an important but not well characterized target for TB control.
We compared infectious TB prevalence from countries with two population-based surveys since 2000, accounting for persons receiving curative treatment and those dying or undergoing natural recovery. Annual incidence was estimated as the proportion of prevalence that, when applied to each year over the interval between the two surveys, yielded the observed second survey prevalence. We then determined the relationship between the proportion of people with TB cured and the change in prevalence in each of the years covered by the surveys.
Achieving a decline in prevalence required curing at least 20% of those with infectious TB. None of the countries studied reached the 11% annual decline in prevalence required to yield the END TB goal of a 90% decrease in prevalence over 20 years; this would require diagnosing and curing 35-40% of people with prevalent TB each year.
These results provide targets for achieving the goal of a 90% reduction in TB and indicate that active case finding will be required to reach these targets.
为降低结核病患病率，需要治愈的传染性结核病患者比例是结核病控制的一个重要但尚未得到充分描述的目标。
我们比较了自2000年以来开展过两次基于人群调查的国家的传染性结核病患病率，同时考虑接受治疗的患者以及死亡或自然康复的患者。年度发病率估计为患病率的比例，将该比例应用于两次调查间隔期间的每一年，得出第二次调查观察到的患病率。然后，我们确定了结核病治愈患者比例与调查所涵盖各年份患病率变化之间的关系。
要实现患病率下降，至少需要治愈20%的传染性结核病患者。所研究的国家均未达到实现“终止结核病”目标（即在20年内将患病率降低90%）所需的每年11%的患病率下降幅度；这需要每年诊断并治愈35%-40%的现患结核病患者。
这些结果为实现结核病患病率降低90%的目标提供了指标，并表明需要积极开展病例发现工作才能实现这些目标。
