全球结核病患病率宏观影响因素分析

Macro analysis of influence factors for tuberculosis prevalence in the world

目的从宏观角度分析探讨影响结核病患病率的因素，为控制结核病疫情提供依据。方法收集全球214个国家结核病及相关因素共15个指标，采用描述性分析、线性回归和广义线性模型进行单因素和多因素分析。结果结核病患病率与15～64岁年龄组构成比、≥65岁年龄组构成比、男性比例、人均医疗卫生支出、15～49岁人口艾滋病病毒感染率和不同国家之间存在统计学相关性（P〈0．01），与城镇人口比例之间不存在相关性（P〉0．05）。随着人均医疗卫生支出的增加，结核病患病率会随之降低；随着15～49岁人口艾滋病病毒感染率的升高，结核病患病率会随之增加。结论为了降低结核病患病率，各国应增加人均医疗卫生支出的投入，积极控制艾滋病的传播，加强结核病患者的病例发现工作。

Objective To understand the influence factors for tuberculosis （TB） prevalence in the world and provide the evidence for TB control. Methods Fifteen variables including TB prevalence and related factors were collected from 214 countries in the world to conduct descriptive analysis, linear regression analysis and general linear model （GLM） analysis. Results TB prevalence was associated statistically with proportions of cases in age groups 15-64 years, /〉65 years, the proportion of male cases, healthcare expenditure per capita, HIV infection rate among people aged 15-64 years and country specific difference （ P 〈 0. 01 ）, but not with urban population proportion （ P 〉 0. 05 ）. TB prevalence declined with the increase of healthcare expenditure per capita, and increased with the increase of HIV infection rate among people aged 15 - 64 years. Conclusion The increase of healthcare expenditure per capita, effective HIV transmission control and strengthened active TB case-finding are key factors to reduce TB prevalence.