自20世紀90年代以來結核病在全球“死灰復燃”，許多國家不同程度地出現了疫情下降緩慢或嚴重反彈的局面，結核病再次成為威脅人類健康的主要傳染病，成為嚴重的公共衛生問題和重大的經濟社會問題。而我國是世界上結核病高負擔國家之一，患者人數僅次于印度居全球第二位。世衛組織2004年召開的第二屆全球遏制結核病伙伴論壇大會上，將我國列在需要特別引起警示的國家和地區的首位。
在另一頭，《美國醫學會雜志》2010年3月12日刊登的一篇文章，發現在2009年美國的結核病監測系統錄得自1953年有記錄以來單年結核病例報告數最大的下降。文章主要探討出現這一現象可能的原因以及采取的相應的公共衛生干預措施對結核病的防控效果，文中還提到人種差異也可能是一個影響因素。我國部分地區結核病疫情回升的原因是多方面，希望閱讀本文能給我們有用的經驗參考學習，感興趣的朋友們可以到以下網址查看全文：http://jama.ama-assn.org/cgi/content/full/303/18/1802
Decrease in Reported Tuberculosis Cases—United States, 2009
2009年美國結核病例報告減少
Every year, CDC reports results from the National TB Surveillance System for the previous year. For 2009, a total of 11,540 tuberculosis (TB) cases were reported in the United States. The TB rate was 3.8 cases per 100,000 population, a decrease of 11.4% from the rate of 4.2 per 100,000 reported for 2008. The 2009 rate showed the greatest single-year decrease ever recorded and was the lowest recorded rate since national TB surveillance began in 1953.1 TB case counts and rates decreased substantially among both foreign-born and U.S.-born persons, although foreign-born persons and racial/ethnic minorities continued to have TB disease disproportionate to their respective populations. The TB rate in foreign-born persons was nearly 11 times higher than in U.S.-born persons. The rates among Hispanics and blacks were approximately eight times higher than among non-Hispanic whites, and rates among Asians were nearly 26 times higher. The large decrease in reported cases during 2009 might represent a decrease in TB disease resulting from changes in population demographics or improved TB control. However, increased underreporting or underdiagnosis of TB also is possible. CDC currently is investigating possible causes for the sharp decrease in reported TB cases. Diagnosing and reporting all TB cases is essential to ensure treatment of patients with TB and implementation of other public health interventions that interrupt transmission.
JAMA. 2010;303(18):1802-1806.
MMWR. 2010;59:289-294
Vol. 303 No. 18, May 12, 2010
（編輯：劉鵬達）
