背景:赞比亚是结核病高负担国家之一。重要的是跟踪在加强病例发现和降低死亡率方面取得的进展。我们回顾了常规结核病报告和死亡率趋势,在赞比亚的所有设施超过十年。
方法:使用联合点分析4.9.0.0版NCI,对结核病通知和死亡趋势进行了为期10年的回顾性研究。我们提取了审查期间的年度国家结核病计划数据。
结果:在2010年至2020年期间,男性和女性的年度平均通知点都有所下降,但女性通报率下降率较高(AAPC=-6.7,95CI:-8.3至-5.0),p<0.001)与男性通知率下降相比(AAPC=-4.1,95CI:-4.1至-5.1,P<0.001)。我们发现经细菌学证实的结核病患者比例显着增长(AAPC=6.1,95%CI:3.6至8.7,p<0.001),而临床诊断患者的比例下降(AAPC=-0.1,95CI:-2.3至2.1,p<0.001)。耐药结核病的通知呈指数增长(AAPC=27.3,95%CI:13至41),p<0.001),而死亡率从2011年的21.3下降到2019年的12.7/10万人口(AAP=-5.6,95CI:-9.6至-1.5,p=0.008)。
结论:本研究说明了审查和分析国家计划常规收集的结核病数据的重要性。该研究揭示了结核病控制方面的改进领域,并强调需要增加和持续投资于病例检测和诊断。
BACKGROUND: Zambia is one of the TB high-burden countries. It is important to track the progress being made towards enhancing case finding and reducing mortality. We reviewed routine TB notifications and mortality trends, over a decade from all facilities in Zambia.
METHODS: A 10-year retrospective study of TB notifications and mortality trends was performed using a Joint Point Analysis version 4.9.0.0, NCI. We extracted the annual national TB program data for the period under
review.
RESULTS: There was a decline in annual point average for notification between 2010 and 2020 in both males and females, but the females notification rates had a higher rate of decline (AAPC = -6.7, 95%CI:-8.3 to -5.0), p<0.001) compared to the decline in males notification rate (AAPC = -4.1, 95%CI:-4.1 to -5.1, P<0.001). We found a significant growth rate in the proportion of TB patients that were bacteriologically confirmed (AAPC = 6.1, 95% CI: 3.6 to 8.7, p< 0.001), while the proportion of clinically diagnosed patients declined (AAPC= -0.1, 95%CI: -2.3 to 2.1, p<0.001). Notification of drug-resistant TB increased exponentially (AAPC=27.3, 95% CI: 13 to 41), p< 0.001) while mortality rate declined from 21.3 in 2011 to 12.7 in 2019 per 100,000 population (AAP=-5.6, 95%CI: -9.6 to -1.5, p=0.008).
CONCLUSIONS: This study has illustrated the importance of reviewing and analyzing routinely collected TB data by national programs. The study revealed areas of improvement in terms of TB control and underscores the need for increased and sustained investment in case detection and diagnostics.