多伦多注射吸毒者中结核分枝杆菌感染的患病率。
Prevalence of Mycobacterium tuberculosis infection among injection drug users in Toronto.
作者信息
Rusen I D, Yuan L, Millson M E
机构信息
Department of Public Health Sciences, University of Toronto, Ont.
出版信息
CMAJ. 1999 Mar 23;160(6):799-802.
BACKGROUND
Injection drug users are at increased risk of Mycobacterium tuberculosis infection and active tuberculosis (TB). The primary objective of this study was to determine the prevalence of M. tuberculosis infection among injection drug users in Toronto, as indicated by a positive tuberculin skin test result. An additional objective was to identify predictors of a positive skin test result in this population.
METHODS
A cross-sectional study was carried out involving self-selected injection drug users in the city of Toronto. A total of 171 participants were recruited through a downtown Toronto needle-exchange program from June 1 to Oct. 31, 1996.
RESULTS
Of 167 subjects tested, 155 (92.8%) returned for interpretation of their skin test result within the designated timeframe (48 to 72 hours). Using a 5-mm cut-off, the prevalence rate of positive tuberculin skin test results was 31.0% (95% confidence interval 23.8% to 38.9%). Birth outside of Canada and increasing age were both predictive of a positive result.
INTERPRETATION
There is a high burden of M. tuberculosis infection in this population of injection drug users. The compliance observed with returning for interpretation of skin test results indicates that successful TB screening is possible among injection drug users.
背景
注射吸毒者感染结核分枝杆菌和患活动性肺结核（TB）的风险增加。本研究的主要目的是确定多伦多注射吸毒者中结核分枝杆菌感染的患病率，以结核菌素皮肤试验结果呈阳性为指标。另一个目的是确定该人群中皮肤试验结果呈阳性的预测因素。
方法
在多伦多市开展了一项横断面研究，研究对象为自我选择的注射吸毒者。1996年6月1日至10月31日期间，通过多伦多市中心的一个针头交换项目招募了171名参与者。
结果
在接受检测的167名受试者中，155名（92.8%）在指定时间范围内（48至72小时）返回查看其皮肤试验结果。以5毫米为临界值，结核菌素皮肤试验结果呈阳性的患病率为31.0%（95%置信区间为23.8%至38.9%）。出生在加拿大境外和年龄增长均为阳性结果的预测因素。
解读
在这群注射吸毒者中，结核分枝杆菌感染负担较重。观察到的返回查看皮肤试验结果的依从性表明，在注射吸毒者中成功进行结核病筛查是可行的。
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