资源描述：
《中国结核感染现状（英文版）》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、LatentInfectionofTuberculosisinChinaHUASHANHOSPITAL,FUDANUNIVERSITY,Shanghai,ChinaWenhongZhang,M.D&PhD.TB:Aleadinginfectiouskiller -top3infectiouskillerTBkillsabout2millionpeopleeachyear8millionpeoplebecomesickwithTBeachyearTBistheleadingkillerofHIV/AIDSpatients50m
2、illionpeopleinfectedwithdrug-resistantTBTheNewTuberculosisHIVandDrug-resistantTB–AlethalcombinationandamajorthreattoTBcontrolWHOdeclaredTBaglobalemergencyin1993TBChemotherapy:THEEffectiveTBControlPre-antibioticera:before1940s(e.g.,codliveroils,bedrest,freshair)Drug
3、susedtotreatTB:StreptomycinfirstTBdrug(1944),followedbyPAS(1946),isoniazid(1952),pyrazinamide(1952),rifampin(1963)(a)Front-lineDrugs:isoniazid(INH)rifampicin(RMP),pyrazinamide(PZA),streptomycin,ethambutol.(b)Second-lineDrugs:PAS,kanamycin,cycloserine,ethionamide,th
4、iacetazone,ciprofloxacin/ofloxacin,rifapentine,amikacin,viomycin,capreomycin.DOTS-TheBestTBTherapy since1991DOTS:6monththerapy-ThebesttherapyagainstTB(78%-96%curerate).Initialphase(daily,2months)with4drugs:INH,RMP,PZA,Ethambutol.Continuationphase(3timesaweek,4month
5、s)with2drugs:INHandRMP.DOTS-PlusDOTS+second-lineTBdrugs(PAS,ethionamide,cycloserine,kanamycin,amikacinetc.)Tooexpensive(TBcase:$11to$100,costoftreatinganMDR-TBcase:$150,000)MDR-TBrequiresextensivechemotherapy(alsomoretoxictopatients-sideeffects)foruptotwoyearsDOTS-
6、PlusworksasasupplementtotheDOTS,toaddressbothdrug-susceptibleandMDR-TBinareaswithsignificantMDR-TB.DiseaseBurdenofTuberculosisinChina,2000dataPrevalenceofactivepulmonarydiseasesis367／100,000PrevalenceofSearpositivepulmonarydiseasesis122／100,000130,000patientsdiefro
7、mtuberculosiseveryyearNodataoflatenttuberculosisinChinauptonowChinaCDC2006PrevalenceofSmearPositiveTuberculosisinChinaIncidenceoftuberculosisaccordingtothereportfromChinaCDCButincidencedonotdecrease!020000040000060000080000010000001200000140000016000002003200420052
8、006ChinaCDC2006FactorscontributetotuberculosisreemerginginChinaMDRTB?HIVincreasing?Latentinfection?Diagnosistoolsaremoreaccuratetofindmorenewcase
