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目标:评价1995年柬埔寨城市和农村地区的结核年感染率(ARTI)以及1955年以来的下降趋势。根据ARTI推算结核病发病率,并与主动病人发现项目以及结核病报告数据进行比较。方法:对两项全国性代表样本共计3524和4407名在校儿童分别进行了ITU的结核菌素——PPD-RT23/Tween80的结核感染皮肤试验。根据ARTI推算的结核病发病率估计值并与主动病人发现项目以及1994年以来采用WHIQ／IUATLD推荐的季度报表病人全国数据进行比较。结果:以10mm硬结反应为界点,1995年柬埔寨的ARTI估计值为0．75％(0．56-0．96％)。1955-1995年Phnom Penh市的ARTI年平均递降率为4．2％,在省级地区为4．9％。根据ARTI推算的结核病发病率估计值比1995年的结核病报告率低2．4倍,比根据人群筛查结果估计的发病率低4．3倍。结论:ARTI随时间推移规律下降。在柬埔寨,根据ARTI推算的结核病发病率数据应该得到正在实施的患病率调查数据的补充。为了获得对国家结核病规划连续的政治支持,需要有更准确的估计。
Objectives: To evaluate the annual prevalence of tuberculosis (ARTI) in urban and rural areas of Cambodia in 1995 and the downward trend since 1955. The incidence of tuberculosis was calculated on the basis of ARTI and compared with active patient discovery and tuberculosis reporting data. METHODS: A total of 3524 and 4,407 schoolchildren from two nationally representative samples were tested for the skin infections of tuberculosis in the ITU with tuberculin-PPD-RT23 / Tween80. Estimates of tuberculosis incidence based on ARTI were compared with those of active patient discovery programs and national data of patients with quarterly WHIQ / IUATLD recommendations since 1994. RESULTS: With a 10mm induration reaction as the cutoff point, the 1995 Cambodian ARTI estimate was 0.75% (0.56-0.96%). The average annual ARTI decline rate in Phnom Penh from 1955 to 1995 was 4.2% and in the provincial area 4.9%. The estimated incidence of tuberculosis based on ARTI is 2.4-times lower than the reported rate of tuberculosis in 1995 and 4.3-times lower than the estimated incidence from population screening. Conclusion: ARTI decreases with time. In Cambodia, the estimated incidence of tuberculosis according to ARTI should be complemented by ongoing prevalence survey data. In order to obtain continuous political support for national tuberculosis programs, more accurate estimates are needed.