初治涂阳肺结核病人及其传染性所致疾病负担的评价方法研究

Methodology on the burden of smear-positive pulmonary tuberculosis and the communicability of the disease

以失能调整寿命年 (DALY)为指标探讨初治的肺结核菌涂片阳性病人及其传染性所致疾病负担的评价方法。以北京市 1994年 794例初治涂阳肺结核病人的性别、年龄发病资料为基础 ,构成了 2 0 0 0人的研究队列。依据大量流行病学数据建立了在不干预 (自然史 )状况下以及在医生直接观察下对结核病短程督导化疗 (DOTS)干预的转归及传染模型。结果表明 ,若不考虑结核传染性所致的潜在疾病负担 ,将有 2 9 6%的DALY损失被忽略。DOTS可减少 92 9%的DALY损失 ,同时降低 99

The burden of patients with smear-positive pulmonary tuberculosis(TB) and that of the communicability of the disease was investigated by using disability-adjusted life year(DALY) as an indicator. An assumed cohort of 2000 cases based on the age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994 was set up. The prognostic tree and diagra m model of communicability under natural history and direct observed treatment short-course start-egy(DOTS) were established according to the epidemiological evidence. The results showed that 29 6% of DALYs would be neglected if the burden caused by the communicability have not been considered. The results also showed that DOTS might reduce 97 3% of potential cases infected, reduce 92 9% of DALY to patient themselves, and reduce 99 9% of DALYs caused by the communicability as well.