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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >A re-examination of the potential impact of preventive therapy on the public health problem of tuberculosis in contemporary sub-Saharan Africa.
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A re-examination of the potential impact of preventive therapy on the public health problem of tuberculosis in contemporary sub-Saharan Africa.

机译：重新研究预防性治疗对当代撒哈拉以南非洲地区结核病公共卫生问题的潜在影响。

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摘要

Background. To estimate the effect size of tuberculosis preventive therapy (PT) on the public health problem of tuberculosis in contemporary sub-Saharan Africa. Methods. A compartmental flow model that considers high levels of tuberculosis and human immunodeficiency virus (HIV) infection in contemporary sub-Saharan Africa was used to assess the impact of PT on the prevalence of tuberculosis and tuberculosis-associated mortality. Results. Model implementation shows that giving PT to 25% of HIV-positive individuals with latent tuberculosis infection (LTBI) leads to a 3.9% reduction in the prevalence of tuberculosis in 10 years and a 5.1% reduction in 20 years. This intervention also prevents a cumulative total of 3.0% of tuberculosis-associated deaths in a decade and 5.5% in two decades. Doubling PT coverage to 50% approximately doubles the effect size, suggesting a linear relationship within the 20-year period. The effect size is slightly sensitive to changes in level of HIV transmission, level of tuberculosis transmission, and level of case detection and treatment cure rates in the population. Conclusions. Contrary to suggestions by previous authors that PT can significantly reduce the public health problem of tuberculosis in sub-Saharan Africa, this model-based analysis suggests that the impact of PT on tuberculosis in the population is likely to be small.
机译：背景。评估结核病预防治疗（PT）对当代撒哈拉以南非洲地区结核病公共卫生问题的影响规模。方法。考虑到在当代撒哈拉以南非洲地区高水平的结核病和人类免疫缺陷病毒（HIV）感染的隔室流动模型用于评估PT对结核病患病率和与结核病相关的死亡率的影响。结果。模型实施显示，对25％的潜伏性结核感染（LTBI）的HIV阳性患者给予PT可以使10年内的结核病患病率降低3.9％，而20年内的患病率降低5.1％。这项干预措施还可以防止十年内累计造成3.0％的结核相关死亡，而在二十年内则可避免5.5％的累积死亡率。将PT覆盖率加倍至50％大约会使效果大小加倍，这表明20年内呈线性关系。效果大小对人群中HIV传播水平，结核病传播水平以及病例检测和治疗治愈率的水平敏感。结论。与以前的作者提出的建议相反，PT可以显着减少撒哈拉以南非洲结核病的公共卫生问题，这种基于模型的分析表明PT对人群中结核病的影响可能很小。

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