老年结核病患者对中国结核病控制的影响

目的 分析在现代结核病控制策略(DOTS策略)下老年结核病患者对中国结核病控制的影响。方法 根据2000年全国结核病流行病学抽样调查中老年结核病的患病特征,对照分析在实施DOTS策略地区和非DOTS策略地区老年结核病患者的发现、治疗和管理现状。结果 ≥65岁年龄组肺结核涂阳患病率为440/10万,是各年龄组平均涂阳患病率的3.6倍;≥65岁老年人涂阳病例数占全人口涂阳病例数的28.6％;在已实施DOTS策略的13个省和未实施DOTS策略的15个省中,老年涂阳病例数分别占各年龄组涂阳病例数的28.8％和28.9％;1992～2000年在实施DOTS策略的13省新涂阳病例登记数中,≥65岁老年结核病患者占11.4％。结论 老年结核病患者涂阳患病率高,不论在实施DOTS策略地区或非DOTS策略地区,所有涂阳病例中老年涂阳病例构成比例大,而新涂阳病例登记比例却最低。老年结核病患病率高、发现率低是结核病控制工作中值得关注的问题。

The impact of geriatric tuberculosis patients on the tuberculosis control strategy in China

Objective To study the current status of geriatric tuberculosis (TB) and its impact on TB control program under the directly observed treatment short-course (DOTS) strategy in China. Methods Using the prevalence information regarding the epidemiology of geriatric TB from the National Random Survey in 2000, a case-control study was carried out to analyze the case detection, treatment and management of geriatric TB patients between DOTS area and non-DOTS area. Results The prevalence of sputum smear positive (SS ) in the age group of 65 or above was 440/100 000 which was 3.6 times of the average prevalence of SS of all age groups. Geriatric SS patients took up 28.8% of all the TB patients in 13 provinces with implementation of DOTS and 28.9% in 15 provinces without. The population of TB casein the age group 65 or above occupied 11.4% of all the newly registered SS case in 13 DOTS provinces from 1992 to 2000. Conclusion The prevalence of geriatric SS was high. In both DOTS and non-DOTS areas, the proportion of geriatric SS was high but the registration rate of new SS was low among all the age groups, Both high prevalence and low case detection rate of geriatric TB became main issues to be under concern in the TB control strategy in China.