van Cleeff M R, Chum H J
Royal Tropical Institute (KIT), Health and Disease Control, Amsterdam, The Netherlands.
Int J Epidemiol. 1995 Jun;24(3):637-42. doi: 10.1093/ije/24.3.637.
Routine data obtained from the National Tuberculosis and Leprosy Programme (NTLP) of Tanzania have shown a constant increase in the notified number of tuberculosis (TB) cases since 1982. Possible causes include an improved reporting system, improvement in health services after the introduction of short course chemotherapy (SCC), and human immunodeficiency virus (HIV) infection. This paper examines to what extent the increased TB case detection rate can be attributed to HIV infection, by calculating the population attributable risk for various years.
The prevalence of HIV infection was obtained from data of the National AIDS Control Programme and the relative risk of HIV for developing TB from a case-control study and the literature.
Between 1985 and 1989 the increase was the highest among women aged 15-24 years and men aged 25-34 years; age groups in which HIV prevalence is highest. In the case-control study HIV prevalence among blood donors was 9.4% and among smear-positive pulmonary TB patients 51.6%, giving an odds ratio (OR) of 8.1 (95% confidence interval (CI): 4.4-16.3). For all TB cases the OR was 11.8. In a population with an HIV prevalence of 10%, about 40% of the smear-positive TB patients are attributable to HIV. The excess of TB cases in the entire country between 1982 and 1989 can be attributable to HIV infection. This has implications for TB control and socioeconomic consequences in the country.
从坦桑尼亚国家结核病和麻风病防治规划（NTLP）获取的常规数据显示，自1982年以来，结核病（TB）病例通报数量持续增加。可能的原因包括报告系统的改善、引入短程化疗（SCC）后卫生服务的改善以及人类免疫缺陷病毒（HIV）感染。本文通过计算不同年份的人群归因风险，研究结核病病例检出率的增加在多大程度上可归因于HIV感染。
HIV感染患病率来自国家艾滋病控制规划的数据，而HIV感染导致结核病的相对风险则来自一项病例对照研究及相关文献。
1985年至1989年间，15 - 24岁女性和25 - 34岁男性中的增长最为显著，这两个年龄组的HIV患病率最高。在病例对照研究中，献血者中的HIV患病率为9.4%，涂片阳性肺结核患者中的患病率为51.6%，比值比（OR）为8.1（95%置信区间（CI）：4.4 - 16.3）。对于所有结核病病例，OR为11.8。在HIV患病率为10%的人群中，约40%的涂片阳性结核病患者可归因于HIV。1982年至1989年间该国结核病病例的增加可归因于HIV感染。这对该国的结核病控制和社会经济后果具有影响。
