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目的 建立中国结核病疫情发展预测模型。方法 根据中国结核病流行病学规律 ,针对Aruma模型的局限性 ,建立联立递推方程模型。利用所建模型对北京市 1979— 2 0 0 0年的疫情发展过程进行模拟 ,并与实际进行比较以评价模型的拟合优度。结果 从活动性肺结核、涂阳肺结核新登记人数、人群结核感染率以及全国结核病流行病学抽样调查结果 4个方面 ,模型的模拟结果与实际拟合良好。模型中可控制因素的灵敏度分析结果提示 ,只有提高了结防机构对肺结核病人特别是涂阳肺结核病人的管理比例后 ,DOTS策略才能发挥显著降低结核病疫情的作用。结论 结核病疫情发展预测模型能良好反映结核病流行实际过程 ,适合对结核病干预措施、控制策略的评价以及疫情发展预测。
Objective To establish a predictive model of tuberculosis epidemic in China. Methods According to the epidemiology of tuberculosis in China, aiming at the limitation of Aruma model, a simultaneous recursive equation model was established. The model was used to simulate the development of epidemic situation in Beijing from 1979 to 2000 and compared with the actual situation to evaluate the goodness of fit of the model. Results From the four aspects of active tuberculosis, newly registered smear-positive pulmonary tuberculosis, population TB infection rate and national tuberculosis epidemiological sampling survey results, the simulation results of the model fits well with the actual situation. Sensitivity analysis of controllable factors in the model suggests that the DOTS strategy can only significantly reduce the outbreak of tuberculosis if the proportion of tuberculosis patients, especially those with smear-positive pulmonary tuberculosis, is increased. Conclusion The prediction model of tuberculosis outbreak development can well reflect the actual process of tuberculosis epidemic and is suitable for the prediction of TB interventions, control strategies and epidemic development.