Lemos Antonio Carlos, Matos Eliana D, Pedral-Sampaio Diana B, Netto Eduardo M
Prof. Edgard Santos Universitary Hospital, Federal University of Bahia, Rua João das Botas, S/N 6o andar, Sala 1124-Canela, 40110-160 Salvador, Bahia, Brazil.
Braz J Infect Dis. 2004 Dec;8(6):424-30. doi: 10.1590/s1413-86702004000600006. Epub 2005 May 9.
Tuberculosis is one of the most important infectious diseases in the world. Only 68% of the estimated new tuberculosis (TB) cases in Brazil are diagnosed. Our aim was to determine the risk of infection among household contacts.
Cohort of tuberculin-negative household contacts followed for 12 months.
Household contacts of randomly selected index acid-fast bacilli (AFB)-positive TB cases were evaluated through clinical examination, thorax X-ray, tuberculin, AFB smear and culture. Contacts with a negative response to the tuberculin test (less than 10 mm diameter) were retested after 90 days. Tuberculin reversal (used as a parameter of infection risk) was defined as an increase of at least 10 mm from the last measurement.
269 household contacts were followed. The prevalence of disease in this population was 3.7%. The prevalence of infection after the 12-month follow-up period was 63.9%. The risk of infection was 31.1% within 120 +/- 48 days.
Household contacts of AFB positive tuberculosis patients have a very high prevalence and risk of tuberculosis infection. TB preventive or therapeutic measures directed towards this group should be implemented in Brazil.
结核病是世界上最重要的传染病之一。在巴西,估计只有68%的新发结核病病例得到诊断。我们的目的是确定家庭接触者中的感染风险。
对结核菌素阴性的家庭接触者进行为期12个月的队列研究。
通过临床检查、胸部X光、结核菌素、抗酸杆菌涂片和培养对随机选择的索引抗酸杆菌(AFB)阳性结核病病例的家庭接触者进行评估。对结核菌素试验反应阴性(直径小于10毫米)的接触者在90天后重新进行检测。结核菌素逆转(用作感染风险参数)定义为比上次测量至少增加10毫米。
对269名家庭接触者进行了随访。该人群中的疾病患病率为3.7%。12个月随访期后的感染患病率为63.9%。在120±48天内感染风险为31.1%。
AFB阳性结核病患者的家庭接触者结核病感染患病率和风险非常高。巴西应针对该群体实施结核病预防或治疗措施。