1990-2017年中国结核病流行与控制情况

Description of epidemic features and control status on tuberculosis in China, 1990-2017

目的分析1990-2017年我国结核病的流行及控制情况,为制定结核病防控策略提供科学依据。方法利用2017年全球疾病负担研究结果,分析1990-2017年中国结核病发病和死亡的变化趋势。结果2017年中国结核病的发病数和死亡数分别是83.10万(年龄标化发病率为54.18/10万)和3.93万(年龄标化死亡率为2.17/10万),较1990年分别下降了51.05%和76.24%。1990-2017年,我国结核病的发病数和死亡数的年均递降率分别为2.61%和5.18%;我国结核病的发病数从2016年的83.36万下降到2017年的83.10万,仅下降了0.31%,死亡数从2016年的4.07万下降到2017年的3.93万,下降了3.44%。1990-2017年药物敏感结核病的发病数和死亡数均呈现逐年下降的趋势,耐多药和广泛耐药结核病的发病数及死亡数均呈现先升后降的趋势。广泛耐药结核病的发病数从2016年的2979例增长到2017年的3018例,增加了1.32%;死亡数从2016年的819例增长到2017年的829例,增加了1.22%。结论1990-2017年我国结核病疫情总体呈下降趋势,但近年来下降速率缓慢,其中广泛耐药结核病的增加应引起重视。

Objective To analyse the epidemic features and programs of control on tuberculosis(TB)in China from 1990 to 2017 to provide references and evidence on prevention and control of the disease.Methods We used data from the Global Burden of Disease Study 2017 to analyse the trends of incident and death cases of TB in China from 1990 to 2017.Results In 2017,there were an estimated 831.0 thousand(age-standardized incidence:54.18 per 100000 population)incident cases and 39.3 thousand(age-standardised mortality:2.17 per 100000 population)deaths of TB in the country.The incident cases and deaths of TB decreased by 51.05%and 76.24%compared with the numbers in 1990,respectively.The average annual declining rates on incident cases and deaths of TB were 2.61%and 5.18%,respectively,from 1990 to 2017.The number of incident cases of TB decreased from 833.6 thousand in 2016 to 831.0 thousand in 2017(decreased by 0.31%).The number of deaths of TB decreased from 40.7 thousand in 2016 to 39.3 thousand in 2017(decreased by 3.44%).The number of incident cases and deaths of drug-sensitive TB showed a declining trend from 1990 to 2017.However,the number of incident cases and deaths showed first increased and then decreased trends for both multidrug-resistant TB(MDRTB)and extensively drug-resistant TB(XDRTB)in the same period.The number of incident cases of XDRTB increased from 2979 in 2016 to 3018 in 2017,with an increasing rate by 1.32%.The number of deaths of XDRTB increased from 819 in 2016 to 829 in 2017,with an increase rate by 1.22%.Conclusions China made substantial progress in reducing both the TB incidence and mortality from 1990 to 2017 but the rate of decline became slow in the later years.We noticed that the increase of TB caused by XDR-TB had been increasing which called for special attention.