Trébucq A, Guérin N, Ali Ismael H, Bernatas J J, Sèvre J P, Rieder H L
Tuberculosis Division, International Union Against Tuberculosis and Lung Disease, Paris, France.
Int J Tuberc Lung Dis. 2005 Oct;9(10):1097-104.
Djibouti, 1994 and 2001.
To estimate the prevalence of tuberculosis (TB) and average annual risk of TB infection (ARTI) and trends, and to test a new method for calculations.
Tuberculin surveys among schoolchildren and sputum smear-positive TB patients. Prevalence of infection was calculated using cut-off points, the mirror image technique, mixture analysis, and a new method based on the operating characteristics of the tuberculin test. Test sensitivity was derived from tuberculin reactions among TB patients and test specificity from a comparison of reaction size distributions among children with and without a BCG scar.
The ARTI was estimated to lie between 2.6% and 3.1%, with no significant changes between 1994 and 2001. The close match of the distributions between children tested in 1994 and patients justifies the utilisation of the latter to determine test sensitivity. This new method gave very consistent estimates of prevalence of infection for any induration for values between 15 and 20 mm. Specificity was successfully determined for 1994, but not for 2001. Mixture analysis confirmed the estimates obtained with the new method.
Djibouti has a high ARTI, and no apparent change over the observation time was found. Using operating test characteristics to estimate prevalence of infection looks promising.
吉布提，1994年和2001年。
估计结核病（TB）患病率、结核病感染年均风险（ARTI）及其趋势，并测试一种新的计算方法。
对学童和痰涂片阳性结核病患者进行结核菌素调查。使用临界点、镜像技术、混合分析以及基于结核菌素试验操作特征的新方法计算感染患病率。试验敏感性来自结核病患者的结核菌素反应，试验特异性来自有和没有卡介苗疤痕儿童反应大小分布的比较。
ARTI估计在2.6%至3.1%之间，1994年至2001年期间无显著变化。1994年检测的儿童与患者之间分布的紧密匹配证明利用后者确定试验敏感性是合理的。对于15至20毫米之间的任何硬结值，这种新方法对感染患病率的估计非常一致。成功确定了1994年的特异性，但2001年未确定。混合分析证实了用新方法获得的估计值。
吉布提的ARTI较高，在观察期内未发现明显变化。利用试验操作特征估计感染患病率看起来很有前景。
