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  • 作者: Li Bing-Ying Shi Wen-Pei Zhou Chang-Ming Zhao Qi Diwan Vinod K Zheng Xu-Bin Li Yang Hoffner Sven Xu Biao
  • 学科: 医药卫生 >
  • 创建时间:2020-08-10
  • 出处:《贫困所致传染病(英文)》 2020年第03期
  • 机构:School of Public Health, Fudan University, Shanghai, China; Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China,School of Public Health, Fudan University, Shanghai, China; Department of Cancer prevention, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden,School of Public Health, Fudan University, Shanghai, China; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China,School of Public Health, Fudan University, Shanghai, China; Key Lab of Health Technology Assessment (Fudan University), National Health Commission, Shanghai, China; Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
  • 简介:AbstractBackground:Multidrug-resistant tuberculosis (MDR-TB) is on the rise in China. This study used a dynamic Markov model to predict the longitudinal trends of MDR-TB in China by 2050 and to assess the effects of alternative control measures.Methods:Eight states of tuberculosis transmission were set up in the Markov model using a hypothetical cohort of 100 000 people. The prevalence of MDR-TB and bacteriologically confirmed drug-susceptible tuberculosis (DS-TB+) were simulated and MDR-TB was stratified into whether the disease was treated with the recommended regimen or not.Results:Without any intervention changes to current conditions, the prevalence of DS-TB+ was projected to decline 67.7% by 2050, decreasing to 20 per 100 000 people, whereas that of MDR-TB was expected to triple to 58/100 000. Furthermore, 86.2% of the MDR-TB cases would be left untreated by the year of 2050. In the case where MDR-TB detection rate reaches 50% or 70% at 5% per year, the decline in prevalence of MDR-TB would be 25.9 and 36.2% respectively. In the case where treatment coverage was improved to 70% or 100% at 5% per year, MDR-TB prevalence in 2050 would decrease by 13.8 and 24.1%, respectively. If both detection rate and treatment coverage reach 70%, the prevalence of MDR-TB by 2050 would be reduced to 28/100 000 by a 51.7% reduction.Conclusions:MDR-TB, especially untreated MDR-TB, would rise rapidly under China’s current MDR-TB control strategies. Interventions designed to promote effective detection and treatment of MDR-TB are imperative in the fights against MDR-TB epidemics.

  • 标签: Multidrug-resistant tuberculosis Markov chains Prevalence Prevention and control