RAMAKRISHNAN C V, ANDREWS R H, DEVADATTA S, FOX W, RADHAKRISHNA S, SOMASUNDARAM P R, VELU S
Bull World Health Organ. 1961;24(2):129-48.
The authors present a second report from the Tuberculosis Chemotherapy Centre, Madras, on the incidence of tuberculosis in close family contacts of tuberculous patients. The patients initially received a year's chemotherapy either at home or in sanatorium in a controlled comparison of the merits of domiciliary as opposed to institutional treatment. The first report presented data relating to the prevalence and the attack rate of tuberculosis among the contacts during the first year of treatment of the index cases; this second report presents the attack rate for the 2-year period since the start of treatment for the index cases. During the second year all the index cases were managed at home, those with active disease, and half of those with quiescent disease, at the end of the first year receiving further chemotherapy. The findings of the 2-year study confirm those of the earlier study-namely, that the incidence of tuberculosis in the contacts of patients originally treated at home was no greater than that in the contacts of patients originally treated in sanatorium and that the major risk to the contacts resulted from exposure to the patient before diagnosis. As in the earlier report, the question of instituting chemoprophylaxis for the young contacts of tuberculous patients is discussed. The authors consider that close family contacts living in over-crowded, urban conditions in the developing countries are valuable groups for chemoprophylactic investigations.
作者们发表了来自马德拉斯结核病化疗中心的第二篇报告，内容是关于结核病患者近亲接触者中的结核病发病率。患者最初接受了为期一年的化疗，化疗地点要么是在家中，要么是在疗养院，以此对家庭治疗与机构治疗的优缺点进行对照比较。第一篇报告呈现了与索引病例治疗第一年期间接触者中结核病的患病率和发病率相关的数据；第二篇报告则呈现了自索引病例开始治疗起两年期间的发病率。在第二年，所有索引病例都在家中接受治疗，那些患有活动性疾病的患者，以及在第一年结束时患有静止性疾病的患者中有一半，接受了进一步的化疗。这项为期两年的研究结果证实了早期研究的结果，即最初在家中接受治疗的患者的接触者中结核病的发病率并不高于最初在疗养院接受治疗的患者的接触者，并且接触者面临的主要风险源于在患者被诊断之前与其接触。与早期报告一样，文中讨论了对结核病患者的年轻接触者进行化学预防的问题。作者们认为，生活在发展中国家拥挤城市环境中的近亲接触者是进行化学预防研究的有价值群体。
