中国麻风流行地区麻风消除目标的预测  

Prediction of Elimination of Leprosy in Leprosy Endemic Areas of China

作　　者：朱成斌[1] 陈祥生[1] 李文忠[1] 江澄[1] 叶干运[1] 

机构地区：[1]中国医学科学院,中国协和医科大学皮肤病研究所,全国性病麻风病控制中心,南京210042

出　　处：《中华皮肤科杂志》2000年第S1期52-56,共5页Chinese Journal of Dermatology

摘　　要：目的 进一步了解我国麻风流行地区的流行病学趋势，预测我国麻风基本消灭目标及 WHO消除麻风公共卫生问题目标在这些地区实现的可能性。方法 利用全国麻风疫情监测系统中 1983～ 1996年间的流行病学资料，借助于流行病学数学模型对我国 1996年底 337个患病率尚未达到国家基本消灭麻风标准的县 (市 )和 40个患病率尚未达到 WHO麻风消除目标的县 (市 )麻风发现率趋势进行了拟合，并根据建立的数学模型对部分地区实现麻风基本消灭和麻风消除目标的时间进行了预测。 结果 在进行预测的 67个患病率未达国家标准的县 (市 )中，在目前防治策略和判愈标准 (中国标准 )不变的情况下，有 6％和 0％的县 (市 )发现率和患病率可望在 2000年前达到国家基本消灭标准， 34.4％和 31.3％的县 (市 )可在 2010年前达到该标准。在进行预测的 11个患病率未达 WHO麻风消除目标的县 (市 )中，据 WHO病例定义标准将有 8～ 10个县 (市 )可望本世纪内达标，而且新发患者中 MB比例增加 10％时，麻风消除的实现将推迟 1年；麻风固定疗程从少菌型 (PB)治疗 6个月和多菌型 (MB)治疗 2年改变为 PB在 9个月和 MB在 3年内完成 MDT疗程，麻风消除的实现将推迟 2～ 10年。结论 到 2000年末，我国 95％以上的县 (市 )可实现Objective To have insight into the epidemiological situation and to predict the possibilities for achieving the national goal of basic eradication or the WHO target of elimination of leprosy as a public health in the leprosy high－ endemic areas in China. Methods Based upon the data during 1983－ 1996 from the National Leprosy Recording and Reporting Surveillance System and using the appropriate mathematical models, the expected calendar year of reaching the national goal in terms of detection and prevalence rates and the WHO target of elimination under different conditions was predicted. Results Of 337 counties where the national goal of basic eradication of leprosy had not reached and 40 counties where the WHO goal of leprosy elimination had not achieved in 1996, the detection rates in calendar years followed the negatively exponential models with a significant goodness－ of－ fit in 67 and 11 counties, respectively. In the former, the national goal can be met in 6％ of counties before the year 2000 or 34.4％ before 2010 in terms of detection rate, or 31.3％ before the year 2010 in terms of prevalence rate. In the latter, the WHO target can be met in 8－ 10 counties within this century when the duration of disease was determined with the WHO definition. While the MB proportion among new cases increased by 10％ , the target would be met one year later. However, at the same MB proportion, the change of the duration of completing the fixed treatment from PB 0.5 year and MB 2 years to PB 0.75 year and MB 3 years will result in the achievement of the goal 2－ 10 years later. Conclusion The results imply that WHO goal of leprosy elimination can be reached in more than 95％ of counties by the end of this century, but the national goal of achieving basic eradication of leprosy in more than 95％ of counties by this century will not be met, indicating that leprosy control will go beyond the century in China.

关 键 词：麻风 预测 发病率 患病率 

分 类 号：R755.01[医药卫生—皮肤病学与性病学]