بررسي اپيدميولوژيك بيماري سل در جنوب غربي ايران: گزارش كوتاه

Epidemiology of Tuberculosis in south-west of Iran: a brief report

زمينه و هدف: بيماری سل شايع‌ترين علت مرگ ناشی از بيماری‌های تك عاملی عفونی در دنيا است و از نظر بارجهانی بيماری (Disability-Adjusted Life Years, DALY)، در رتبه دهم قرار دارد. مطالعه حاضر با هدف بررسی اپيدميولوژيك بيماری سل اجرا گرديد. روش بررسی: در اين مطالعه گذشته‌نگر توصيفی- تحليلی در استان خوزستان طی سال‌های 1384 تا1391، پرونده 6363 بيمار مبتلا به سل با روش سرشماری بررسی شد. با استفاده از نرم‌افزار TB Register متغيرهای دموگرافيك و اطلاعات اپيدميولوژيك و بالينی ثبت گرديد و از طريق نرم‌افزار SPSS ويراست 16 مورد تجزيه و تحليل قرارگرفتند. يافته‌ها: ميانگين سن بيماران 18±3/39 سال بود كه ميانگين سن زنان به طور متوسط 1/2 سال از مردان بيشتر بود (0001/0P=). از كل بيماران 7/75% مبتلا به سل ريوی و 7/2% آلوده به HIV بودند. روند تغييرات ميزان بروز سل در سال‌های مورد مطالعه معنادار بود (05/0>P). نتيجه‌گيری: ابتلای همزمان عفونت HIV و بيماری سل در جنوب غربی ايران شيوع بالايی دارد. غربالگری، آموزش و اقدامات پيشگيرانه جهت كنترل بيماری سل توصيه می‌شود.

Background: Tuberculosis is still one of the main causes of mortality and disability in developing countries. Despite of socio-economic development of communities and controlling majority of communicable diseases, With respect to importance and high incidence of Tuberculosis in marginal provinces, the present study was aimed to assess the epidemiology of Tuberculosis. Methods: In this Descriptive-Analytical Retrospective Study, documents of 6363 patients diagnosed with TB in the beginning of March 2005 to the end of the September 2012 in Khuzestan province, Iran, by used census sampling size, were used. Demographic variables and other necessity data were recorded by TB-Register software and then these data were analyzed by SPSS 16.0 software and Chi-square and independent t-tests with a significance level of less than 5%. For comparison Tuberculosis incidence in consecutive years used by Poisson tests (with a significance level of less than 5%). Results: mean age of patients and median age of patients were 39.3±18 and 35±6.5 years, for women mean age was older 2.1 years than men and there was significant relationship to age (P=0.0001). Of all patients 75.7% were pulmonary tuberculosis, 2.7% were infected with HIV and 91.2% were new cases. Cumulative incidence in province was 148.84/100,000. Most prevalent in Non-pulmonary TB was Lymphatic glands. Poisson test showed that changing trends of TB incidence in study years was statistically significant (P<0.05). Conclusion: Increasing concurrent of HIV infection and TB and decreasing patients mean age (39.3±18) and median (35±6.5) in southwest of Iran has high prevalence. Screening, training and preventive activities for controlling of disease is highly recommended for the whole country and in margin provinces in particular.