涂片阳性肺结核病人及其传染性疾病负担方法学的研究

Methodology of the burden of disease with smear_positivepulmonary tuberculosis and its infectivity

目的 探讨利用 Ｄ Ａ Ｌ Ｙ 指标测量涂片阳性肺结核病人及其传染性疾病负担的方法。方法 以北京市１９９４ 年７９４ 例新登记涂阳肺结核病人的年龄别发病率为基础，构成２０００ 人的研究队列，依据现有的流行病学资料，建立了结核病自然史以及采取 Ｄ Ｏ Ｔ Ｓ 干预的转归图及传染模型。结果 若不考虑结核传染性造成的潜在疾病负担，将有２９６ ％ 的 Ｄ Ａ Ｌ Ｙ 损失会被忽略。结论 Ｄ Ｏ Ｔ Ｓ 可减少９２９ ％ 的 Ｄ Ａ Ｌ Ｙ 损失，同时可降低９９９ ％ 由于传染所致的 Ｄ Ａ Ｌ Ｙ 损失。

Objective To explore a methodology of the Disability_ Adjusted Life Year( D A L Y) with smear_positivepulmonary tuberculosis and itsinfectivity . Method An assumed cohort of 2 000 cases was set up based on the age_specificincidence of 794 newly registered smear positive casesin Beijing in 1994 . Prognostic trees and model diagrams ofinfectivitywith natural history and D O T Sinterventions were constructed according to the epidemiology evidence . Results The re sultsshow that it would be neglect 29 .6 % of D A L Y S without consideration of the D A L Y caused by its infectivity . Conclusion D O T Sstrategy could not only reduce 92 .9 % of D A L Y Srelated to T B patient itself but also 99 .9 % of D A L Y Scaused by itsinfectivity .