论文部分内容阅读
背景:摩洛哥从20世纪90年代初期就开始实施世界卫生组织(WHO)推荐的DOTS策略,但在1996—2005年间结核病人报告率的年递降率仅为3%～4%。以目前的疫情下降趋势,到2050年(即实现全球消灭结核病的目标年),摩洛哥仍将新发生1万例以上的结核病人。方法:对1996—2005年间国家结核病控制规划报告的病人,按年龄、性别、临床分型和地区进行分析。以4个标准判断观察结果的准确性:统计学有效性、测量精度、生物学合理性,以及不同证据链显示的一致性和关联强度。结果:城市地区的结核病发病(病人数和发病率)高于农村,成年男性的发病率高于女性。男性结核病人中,痰涂片阳性(最具传染性)的比例高于女性。2005年,在所有痰涂片阳性病人中, 15～44岁的男性占了近一半。男性的发病率下降速度低于平均水平,但女性发病率的下降速度也较预期的慢。结论:在摩洛哥,城市男性人群是结核病防治的重点对象。就总体而言,应对常规监测数据进行深入研究,以发挥其对结核病控制活动的指导作用。
Background. Morocco implemented the DOTS strategy recommended by the World Health Organization (WHO) since the early 1990s. However, the annual decline rate of reported tuberculosis patients in 1996-2005 was only 3% -4%. With the current downward trend in epidemic situation, by the year 2050 (that is, the target year of achieving global elimination of tuberculosis), more than 10,000 tuberculosis cases will still occur in Morocco. Methods: The patients reporting from the national tuberculosis control program from 1996 to 2005 were analyzed by age, sex, clinical classification and region. The accuracy of the observations was judged by four criteria: statistical validity, measurement accuracy, biological plausibility, and concordance and correlation strength between different evidence chains. Results: The incidence of tuberculosis (number of patients and morbidity) in urban areas was higher than that in rural areas, and the incidence of adult men was higher than that of women. Among men with tuberculosis, sputum smear positive (the most contagious) than the proportion of women. In 2005, men aged 15-44 accounted for nearly half of all sputum smear-positive patients. Men’s rates of decline have dropped below average, but the decline in women’s rates has also been slower than expected. Conclusion: In Morocco, male urban populations are the focus of tuberculosis prevention and control. In general, in-depth studies of routine surveillance data should be conducted in order to exert their guiding role on tuberculosis control activities.