AIDS-Related Tuberculosis in Rio de Janeiro, Brazil 英文参考文献.docVIP

AIDS-RelatedTuberculosisinRiodeJaneiro,Brazil AntonioG.Pacheco1,BetinaDurovni3,4,SolangeC.Cavalcante2,3,L.M.Lauria3,RichardD.Moore6,7, LawrenceH.Moulton8,RichardE.Chaisson5,6,7,8,JonathanE.Golub5,6,7 * 1ENSP/PROCC,FIOCRUZ,RiodeJaneiro,Brazil,2IPEC,FIOCRUZ,RiodeJaneiro,Brazil,3MunicipalHealthSecretariat,RiodeJaneiroCity,Brazil,4FederalUniversityofRio deJaneiro,RiodeJaneiro,Brazil,5CenterforTuberculosisResearch,JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica,6DepartmentofMedicine, JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica,7DepartmentofEpidemiology,JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesof America,8DepartmentofInternationalHealth,JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica Abstract Background:Westudiedtheincidenceoftuberculosis,AIDS,AIDSdeathsandAIDS-TBco-infectionatthepopulationlevel inRiodeJaneiro,Brazilwhereuniversalandfreeaccesstocombinationantiretroviraltherapyhasbeenavailablesince1997. Methodology/PrincipalFindings:ThiswasaretrospectivesurveillancedatabasematchofRiodeJaneirodatabasesfrom 1995–2004.Proportionsoftuberculosisoccurringwithin30daysandbetween30daysand1yearafterAIDSdiagnosiswere determined. Generalized additive models fitted with cubic splines with appropriate estimating methods were used to describe ratesandproportions overtime. Overall, 90,806 tuberculosis cases and16,891 AIDS cases werereported; 3,125 tuberculosiscaseswithin1yearofAIDSdiagnosisweredetected.Tuberculosisnotificationratesdecreasedafter1997froma fittedrate(fRper100,000)of166.5to138.8in2004.AIDSincidenceratesincreased26%between1995and1998(30.7to 38.7)followedbya33.3%decreaseto25.8in2004.AIDSmortalityratesdecreaseddramaticallyafterantiretroviraltherapy was introduced between 1995 (27.5) and 1999 (13.4). The fitted proportion (fP) of patients with tuberculosis diagnosed within one year of AIDS decreased from 1995 (24.4%) to1998 (15.2%), remaining stable since. Seventy-five percent of tuberculosisdiagnosesafteranAIDS