2000—2015年全球结核病患病率宏观影响因素分析

Analysis of the macro influencing factors of global tuberculosis prevalence from 2000 to 2015

目的从宏观角度分析2000—2015年全球结核病患病率的影响因素,为了解全球结核病发展情况及控制结核病疫情提供相应依据。方法根据WHO和世界银行开放式数据库收集全球209个相关国家结核病患病率及其相关因素共13个指标,包括人口学、经济学、社会学和生物学宏观指标等。采用描述性分析、单因素及多因素线性回归分析。结果2000—2015年全球肺结核患病率呈逐年下降趋势,全球结核病患病率与15~64岁年龄别构成比(r=0.006,P<0.05)、女性性别构成比(r=0.063,P<0.01)、15~49岁人口艾滋病病毒感染率之间存在正相关(r=0.693,P<0.01),与≥65岁年龄别构成比(r=-0.162,P<0.01)、公共医疗卫生总支出百分比(r=-0.091,P<0.01)、人均医疗卫生支出(r=-0.227,P<0.01)、城镇人口比例成负相关(r=-0.064,P<0.01)。结论各国家应适当增加医疗卫生总支出百分比和人均医疗卫生支出,针对不同人群应采取相应的卫生政策,有效控制艾滋病的感染率,做好结核病的宣传教育工作。

Objective To analyze the factors influencing the global prevalence of tuberculosis from 2000 to 2015 from a macroscopic perspective,and to provide a corresponding basis for understanding the global development of tuberculosis and controlling the tuberculosis epidemic.Methods A total of 13 indicators,including demographic,economic,sociological and biological macroscopic indicators,were collected on the basis of WHO and World Bank open databases on the prevalence of tuberculosis and its associated factors in 209 relevant countries worldwide were collected.Descriptive analysis,univariate and multivariate linear regression analysis were performed.Results The global prevalence of tuberculosis showed a decreasing trend from 2000 to 2015,and the global prevalence of tuberculosis was correlated with the age composition ratio of 15~64 years old(r=0.006,P<0.05),female sex composition ratio(r=0.063,P<0.01),and HIV prevalence of 15~49 years old(r=0.693,P<0.01).And the percentage of total public health care expenditure(r=-0.091,P<0.01),per capita health care expenditure(r=-0.227,P<0.01),and the proportion of urban population(r=-0.064,P<0.01)were negatively correlated.Conclusion Countries should appropriately increase the percentage of total health care expenditure and per capita health care expenditure,adopt appropriate health policies for different populations,effectively control the infection rate of AIDS,and do a good job in the publicity and education of tuberculosis.