Murray C J, Salomon J A
Center for Population and Development Studies, Harvard School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA.
Proc Natl Acad Sci U S A. 1998 Nov 10;95(23):13881-6. doi: 10.1073/pnas.95.23.13881.
An epidemiological model of tuberculosis has been developed and applied to five regions of the world. Globally, 6.7 million new cases of tuberculosis and 2.4 million deaths from tuberculosis are estimated for 1998. Based on current trends in uptake of the World Health Organization's strategy of directly observed treatment, short-course, we expect a total of 225 million new cases and 79 million deaths from tuberculosis between 1998 and 2030. Active case-finding by using mass miniature radiography could save 23 million lives over this period. A single contact treatment for tuberculosis could avert 24 million cases and 11 million deaths; combined with active screening, it could reduce mortality by nearly 40%. A new vaccine with 50% efficacy could lower incidence by 36 million cases and mortality by 9 million deaths. Support for major extensions to global tuberculosis control strategies will occur only if the size of the problem and the potential for action are recognized more widely.
一种结核病的流行病学模型已被开发出来并应用于世界五个地区。全球范围内，1998年估计有670万例新的结核病病例以及240万人死于结核病。基于目前世界卫生组织直接观察治疗短程疗法的采用趋势，我们预计在1998年至2030年期间，结核病新发病例总数将达2.25亿例，死亡人数将达7900万例。在此期间，通过大规模微型放射摄影进行主动病例发现可挽救2300万人的生命。针对结核病的单次接触者治疗可避免2400万例病例和1100万人死亡；与主动筛查相结合，可将死亡率降低近40%。一种效力为50%的新疫苗可使发病率降低3600万例，死亡率降低900万人。只有当这个问题的规模和采取行动的潜力得到更广泛认可时，才会有对全球结核病控制策略进行重大扩展的支持。
