Sánchez-Pérez Héctor J, Hernán Miguel A, Hernández-Díaz Sonia, Jansá Josep M, Halperin David, Ascherio Alberto
Department of Epidemiology and Public Health, El Colegio de la Frontera Sur (Ecosur), San Cristóbal de las Casas, Chiapas, Mexico.
Ann Epidemiol. 2002 Apr;12(3):166-72. doi: 10.1016/s1047-2797(01)00308-8.
To estimate the prevalence of undiagnosed pulmonary tuberculosis (PTB) and the sensitivity of bacilloscopy in the border region of Chiapas, Mexico.
We actively sought individuals aged 15 years or more with chronic cough from the Border Region of Chiapas, Mexico in three settings: one regional hospital, seven Primary Care Centers (PCC), and 32 communities. Individuals (a total of 899) reporting chronic cough were asked to provide three samples of sputum for acid-fast smears and cultures. The quality of acid-fast smears was evaluated using culture as the gold standard.
We obtained sputum specimens from 590 of 899 individuals with chronic cough. A diagnosis of PTB was confirmed in 78. A conservative estimate of the overall prevalence of PTB at the population level was 151 per 100,000 (95% CI: 88 to 241). In the regional hospital, the estimated case detection rate was 66% (29/44). The proportion of candidates for PTB therapy that were actually on treatment was 50% (14/28) at the PCC and 11% (2/19) in the communities. The sensitivity of the bacilloscopy was about 90% in the hospital, and slightly lower than 50% in the PCC and the communities.
Improved procedures for PTB detection are required in the studied area to adequately control the disease and to provide therapy to affected patients.
评估墨西哥恰帕斯州边境地区未被诊断出的肺结核（PTB）患病率以及痰涂片镜检的敏感性。
我们在墨西哥恰帕斯州边境地区的三个场所积极寻找15岁及以上的慢性咳嗽患者：一家地区医院、七个初级保健中心（PCC）和32个社区。要求报告慢性咳嗽的个体（共899人）提供三份痰样本用于抗酸涂片和培养。以培养作为金标准评估抗酸涂片的质量。
我们从899名慢性咳嗽个体中获取了590份痰标本。确诊为PTB的有78例。在人群水平上，PTB总体患病率的保守估计为每10万人中有151例（95%置信区间：88至241）。在地区医院，估计的病例检出率为66%（29/44）。在初级保健中心，实际接受PTB治疗的候选患者比例为50%（14/28），在社区为11%（2/19）。在医院，痰涂片镜检的敏感性约为90%，在初级保健中心和社区略低于50%。
在研究地区需要改进PTB检测程序，以充分控制该疾病并为受影响的患者提供治疗。
