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1、结核与HIV:全球流行病学,诊断,和治疗DavidCohn,MD世界健康基金会丹佛公共健康科罗拉多大学健康科学中心March,2007成人和儿童感染HIV的情况-2005总数:4030万Western&CentralEurope720000[570000–890000]NorthAfrica&MiddleEast510000[230000–1.4million]Sub-SaharanAfrica25.8million[23.8–28.9million]EasternEurope &CentralAsia1.6million[990000–2.3million]South&Sou
2、th-EastAsia7.4million[4.5–11.0million]Oceania74000[45000–120000]NorthAmerica1.2million[650000–1.8million]Caribbean300000[200000–510000]LatinAmerica1.8million[1.4–2.4million]EastAsia870000[440000–1.4million]2002年估计结核的感染率25to4950to99100to299<1010to24300ormoreNoEstimateper100000populationThebou
3、ndariesandnamesshownandthedesignationsusedonthismapdonotimplytheexpressionofanyopinionwhatsoeveronthepartoftheWorldHealthOrganizationconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedlinesonmapsrepresentapp
4、roximateborderlinesforwhichtheremaynotyetbefullagreement.©WHO2002估计2002结核新的感染病例10000to99999100000to9999991000000ormore<10001000to9999NoEstimateTheboundariesandnamesshownandthedesignationsusedonthismapdonotimplytheexpressionofanyopinionwhatsoeveronthepartoftheWorldHealthOrganizationconcerning
5、thelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement.©WHO2002≈200,000newcasesMDR-TB≈700,000新的HIV+患者结核和HIV共存的流行情况潜在的相互作用HIV的传播(血,体液)HIV感染结核感
6、染结核的传播(空气)影响HIV感染的发病机制增加发病率和死亡率增加结核的感染率和再染不典型的临床表现赞比亚津巴布韦肯尼亚马拉维坦桑尼亚结核在非洲的趋势,1980-2002 HIVDrivingtheTBEpidemicHIV促进了TB的流行估计成人结核合并HIV感染的分布,200050,000450,000SS非洲9.5million150,00050,000100,000400,000SE亚洲2.3million5,000全球总数:1300万世界卫生组织WHO,2007EpidemiologyofTuberculosisinChina 2005Estimates人口(千)新发
7、病率(所有病例/100,000/年)流行情况(所有病例/100,000/年)死亡率(死亡人数/100,000/年)OfnewTBcases(15-49yrs),%HIV+OfHIVpatientsscreened,%withTBNo.CasesTB/HIV新的结核病例,MDR(%)之前治疗的结核患者,MDR(%)1,315,844100208160.56.66,0005.327诊断结核的方法痰涂片查抗酸杆菌(涂片的显微镜检查)在全世界运用的最广泛的诊断结核的方法肺结核的患者中大概50%为阳性
