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[结核病及其对抗结核药物的耐药性流行病学]

[The epidemiology of tuberculosis and of the resistance to antitubercular agents].

作者信息

Aït Khaled N, Enarson D, Billo N

机构信息

Union Internationale Contre la Tuberculose et les Maladies Respiratoires (UICTMR), Paris.

出版信息

Rev Mal Respir. 1997 Dec;14 Suppl 5:S8-18.

PMID:9496587
Abstract

Tuberculosis is once more a subject of world wide preoccupation; since 1985 a disturbing recrudescence of this disease has been noted in numerous countries related to population growth and the worsening of poverty in those countries without natural resources, and disadvantaged groups living on the margins of society in rich countries, along with the occurrence of an epidemic of HIV (VIH). In numerous developed countries where tuberculosis no longer represents a public health problem, the care services have little by little been closed or re-orientated and the principles of treatment of tuberculosis have been forgotten. The direct consequence of this has often been inadequate treatment and its corollary: the emergence of strains multiresistant to Isoniazid and Rifampicin. If the current epidemiological tendencies are confirmed and no supplementary action is taken, the WHO (OMS) has estimated that during the ten years between 1990 and the millennium there will be 88 million new cases of tuberculosis and 30 million people will die of tuberculosis. However the tendencies can be reversed and tuberculosis could still be eliminated. The struggle against tuberculosis is a world wide emergency and the hope of controlling the situation before an increase in multiresistant strains which would render the trend irreversible, rests on a general application of correct and coherent national programmes. Such a programme as the UICTMR model had already been carried out as has the proof of their efficacy.

摘要

结核病再次成为全球关注的问题;自1985年以来,在许多国家都注意到这种疾病令人不安地再度流行,这与人口增长以及那些没有自然资源的国家贫困状况的恶化有关,也与富裕国家处于社会边缘的弱势群体以及艾滋病毒(HIV)的流行有关。在许多结核病不再构成公共卫生问题的发达国家,医疗服务已逐渐关闭或重新调整方向,结核病治疗原则也被遗忘。其直接后果往往是治疗不充分及其必然结果:出现对异烟肼和利福平多重耐药的菌株。如果当前的流行病学趋势得到证实且不采取额外行动,世界卫生组织(WHO)估计,在1990年至千禧年的十年间,将有8800万新的结核病病例,3000万人将死于结核病。然而,这些趋势是可以扭转的,结核病仍有可能被消除。抗击结核病是全球的紧急任务,要在多重耐药菌株增加到使趋势不可逆转之前控制住局面,希望寄托在正确且连贯的国家方案的普遍实施上。像UICTMR模式这样的方案已经实施,并且其有效性也已得到证明。

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