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目的:观察日本目前结核病流行病学趋势并确定与发病率、死亡率恶化趋势有关的因素。 设计:结核病报告率和年龄、性别、出生队列的死亡率的描述性分析。 结果:结核病报告率的下降大约从1980年开始缓慢减少。在1950年以前的出生队列中,按照年龄的报告率趋势约从1980年以后保持稳定。结核病死亡率的下降最近也开始缓慢减少,但比报告率下睁的起步要晚,程度要小。虽然因结核病死亡的大多发生在老年人当中,中年男性的死亡率下降在近期也缓慢减少。出生队列的死亡率随着年龄的增加有上升趋势。 结论:目前报告率的下降出现停滞的一个主要原因是过去感染结核病的高患病率的老年人口的增加,当他们接近生物学衰老时,更可能容易发病。其他可能的原因是城市人口中结核病人群逐渐丧失社会-经济地位,以及一些作法的改变导致病例发现延误。
OBJECTIVE: To observe the current epidemiological trends of tuberculosis in Japan and to determine the factors associated with the morbidity and mortality. Design: Descriptive analysis of tuberculosis reporting rates and age, sex, and birth cohort mortality. Results: The decline in tuberculosis reporting rates began to decline slowly around 1980. In the birth cohorts prior to 1950, the trend of reporting by age remained stable from around 1980 onwards. The decline in tuberculosis mortality has also begun to decline slowly recently, but to a lesser extent than the start of the reporting rate. Although the majority of deaths due to tuberculosis occur among the elderly, the decline in mortality among middle-aged men is also slowly declining in the near future. Birth cohort mortality increases with age. Conclusion: One of the main reasons for the current stagnation in reported rates of decline is the increase in the elderly population with a high prevalence of tuberculosis in the past, as they are more likely to become morbid when approaching biological aging. Other possible causes are the gradual loss of socio-economic status of the TB population in the urban population and some changes in practices leading to delays in the detection of cases.