Worldwide trends in epidemiology and control of tuberculosis / 第二军医大学学报

ABSTRACT

Tuberculosis (TB) is a global burden disease and is being resurrected as a major worldwide public health problem after two decades of neglect.In 1993,the World Health Organization (WHO) declared that TB had been a global emergency because of the scale of the epidemic and the urgent need to improve global tuberculosis control.China is one of the countries with the largest population,and also the top of the 22 TB high-burden countries in the world.In the United States,the longstanding downward trend in TB incidence was interrupted in the mid-to-late 1980s,where the national TB incidence peaked in 1992.Sub-Saharan Africa is one of the three regions to dominate the worldwide distribution of notified TB cases.Of the 15 countries with the highest estimated tuberculosis incidence rates in the world,13 are in sub-Saharan Africa,where HIV is the most important single predictor of tuberculosis incidence.The largest share of the global burden of HIV-related tuberculosis falls on this region.The reasons for the persisting global tuberculosis burden include increased poverty in some regions,immigration from countries with high tuberculosis prevalence,the impact of HIV,and most importantly,the failure to maintain the necessary public health infrastructure under the mistaken belief that tuberculosis was a problem of the past.Relying on currently available methods of diagnosis and treatment,the DOT strategy promoted by the WHO for global tuberculosis control is effective,affordable,and adaptable in different settings.