頁籤選單縮合
題名 | 抗藥性結核病防治十年有成=Challenges and Progress of Drug Resistant Tuberculosis Control in Taiwan, 2007-2016 |
---|---|
作者 | 彭彥婷; 詹珮君; 劉璟函; 李品慧; 李佳琪; 黃彥芳; Peng, Yen-ting; Chan, Pei-chun; Liu, Ching-han; Lee, Pin-hui; Lee, Chia-chi; Huang, Yen-fang; |
期刊 | 疫情報導 |
出版日期 | 20190129 |
卷期 | 35:2 2019.01.29[民108.01.29] |
頁次 | 頁17-25 |
分類號 | 412.42 |
語文 | chi |
關鍵詞 | 抗藥性結核病; 抗藥性結核病醫療照護團隊; Drug-resistant tuberculosis; Taiwan MDR-TB Consortium; TMTC; MDR-TB; RR-TB; |
中文摘要 | 抗藥性結核病已成為全球健康威脅。依據世界衛生組織2016年全球結核病年報資料,抗藥性結核病診斷及治療的危機持續上升,於2015年全球即新增約48萬名多重抗藥性結核(multidrug-resistant tuberculosis, MDR-TB)病人,以及至少10萬名rifampicin單一抗藥(rifampicin-resistant tuberculosis, RR-TB)病人。有鑒於抗藥情形日益嚴重,疾病管制署於2007年開始陸續進行MDR-TB之通報管理作業、加強抗藥性結核病個案接觸者追蹤管理、提供抗藥性結核菌分子快速檢測及管控Fluoroquinolones類藥物等措施,並於2007年5月建置「抗藥性結核病醫療照護體系」,迄今已屆滿10年。 10年來我國抗藥性結核病疫情明顯趨緩,MDR-TB病人管理及通報個案數下降,MDR-TB在管人數已由2007年的440人降為2016年的168人,通報人數由2009年178人逐年下降至2016年的117人。加入照護體系的MDR-TB病人追蹤24個月治療成功率,亦由2007年世代的59.4%上升到2015年的72.5%,追蹤36個月治療成功率,由2007年世代個案的84.6%上升到2014年世代的90%。在良好的個案管理體系之下,廣泛性多重抗藥性結核病及慢性個案亦大幅減少。 未來MDR-TB新發生個案的下降仍需靠公衛的努力,尤其是個案監測及發現、接觸者匡列及檢查的落實。另外,境外MDR-TB個案移入、抗藥性個案持續減少致抗藥性結核病醫療照護體系存續困難,結核病公衛個管基層人力常顯不足,這些都是未來維持目前抗藥性結核病防治成效的挑戰。 |
英文摘要 | Drug-resistant tuberculosis (DR-TB) has become a serious threat to global health. According to 2016 WHO global tuberculosis report, the crisis of multidrug-resistant tuberculosis (MDR-TB) detection and treatment continued In 2015, there were around 480,000 new cases of MDR-TB and 100,000 cases with rifampicin-resistant tuberculosis (RR-TB). In order to enhance the DR-TB epidemic control, the Taiwan Centers for Disease Control (TCDC) has launched several strategies since 2007, including the initiation of MDR-TB case reporting, enhancement of DR-TB contacts investigation and follow-up, provision of rapid molecular drug-resistance tests, and control of quinolone antimicrobial drugs. Furthermore, a new MDR-TB program, the Taiwan MDR-TB Consortium (TMTC), was established by TCDC in May 2007. For the past decade, DR-TB epidemic of Taiwan has declined significantly since 2007. The number of MDR-TB cases under management decreased from 440 cases in 2007 to 168 cases in 2016, and the number of reported MDR-TB cases decreased from 178 cases in 2009 to 117 cases in 2016 as well. The treatment success rate at 24 months for patients enrolled in the TMTC increased from 59.4% in 2007 to 72.5% in 2015, and the treatment success rate at 36 months increased from 84.6% in 2007 to 90% in 2014. Under the TMTC, a proper MDR-TB case management program, the number of extensively drug resistant tuberculosis (XDR-TB) and chronic cases have also been effectively reduced. The future decline of new cases of MDR-TB relies on strengthening implementation of DR-TB case finding, contact investigation, and follow-up for contacts. Besides, MDR-TB cases importation, sustainability of the TMTC, and inadequate manpower of public health workers are the persisted challenges for preserving the achievements of DR-TB control. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。