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1、結(jié)核與HIV:全球流行病學(xué),診斷,和治療DavidCohn,MD世界健康基金會(huì)丹佛公共健康科羅拉多大學(xué)健康科學(xué)中心March,2007成人和兒童感染HIV的情況-2005總數(shù):4030萬(wàn)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年估計(jì)結(jié)核的感染率25to4950to99100to299<1010to24300ormoreNoEstimateper100000populationThebou
3、ndariesandnamesshownandthedesignationsusedonthismapdonotimplytheexpressionofanyopinionwhatsoeveronthepartoftheWorldHealthOrganizationconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedlinesonmapsrepresentapp
4、roximateborderlinesforwhichtheremaynotyetbefullagreement.?WHO2002估計(jì)2002結(jié)核新的感染病例10000to99999100000to9999991000000ormore<10001000to9999NoEstimateTheboundariesandnamesshownandthedesignationsusedonthismapdonotimplytheexpressionofanyopinionwhatsoeveronthepartoftheWorldHealthOrganizationconcerning
5、thelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement.?WHO2002≈200,000newcasesMDR-TB≈700,000新的HIV+患者結(jié)核和HIV共存的流行情況潛在的相互作用HIV的傳播(血,體液)HIV感染結(jié)核感
6、染結(jié)核的傳播(空氣)影響HIV感染的發(fā)病機(jī)制增加發(fā)病率和死亡率增加結(jié)核的感染率和再染不典型的臨床表現(xiàn)贊比亞津巴布韋肯尼亞馬拉維坦桑尼亞結(jié)核在非洲的趨勢(shì),1980-2002 HIVDrivingtheTBEpidemicHIV促進(jìn)了TB的流行估計(jì)成人結(jié)核合并HIV感染的分布,200050,000450,000SS非洲9.5million150,00050,000100,000400,000SE亞洲2.3million5,000全球總數(shù):1300萬(wàn)世界衛(wèi)生組織WHO,2007EpidemiologyofTuberculosisinChina 2005Estimates人口(千)新發(fā)
7、病率(所有病例/100,000/年)流行情況(所有病例/100,000/年)死亡率(死亡人數(shù)/100,000/年)OfnewTBcases(15-49yrs),%HIV+OfHIVpatientsscreened,%withTBNo.CasesTB/HIV新的結(jié)核病例,MDR(%)之前治療的結(jié)核患者,MDR(%)1,315,844100208160.56.66,0005.327診斷結(jié)核的方法痰涂片查抗酸桿菌(涂片的顯微鏡檢查)在全世界運(yùn)用的最廣泛的診斷結(jié)核的方法肺結(jié)核的患者中大概50%為陽(yáng)性
