Moonan Patrick K, Oppong Joseph, Sahbazian Behzad, Singh Karan P, Sandhu Raghbir, Drewyer Gerry, Lafon Terry, Marruffo Marco, Quitugua Teresa N, Wallace Charles, Weis Stephen E
School of Medicine, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX 76107, USA.
Am J Respir Crit Care Med. 2006 Sep 1;174(5):599-604. doi: 10.1164/rccm.200512-1977OC. Epub 2006 May 25.
Identifying and treating persons with latent tuberculosis (TB) infection (LTBI) at high risk for developing TB is part of the current TB elimination strategy. There are no specific criteria, other than medical risks, to designate groups as high risk for developing TB. We hypothesized that, if location-based screenings were done in communities where persons with genotypically clustered Mycobacterium tuberculosis resided, then persons with LTBI from recent transmission and with undiagnosed TB could be identified.
Location-based TB screenings were done in partnership with multiple community-based organizations using resources previously used for other types of screening.
Location-based screenings identified one person with TB for every 83 screened, and one person with LTBI for every five screened. The yield of this targeted screening program for discovering persons with TB and LTBI exceeded what would be expected from nontargeted screening in a county with a TB incidence of 5.7 per 100,000 population.
Genotyping combined with geographic information systems analysis can potentially be used to define high-risk status and to define areas for location-based TB screenings.
识别并治疗有潜伏性结核（TB）感染（LTBI）且发展为结核病风险高的人群是当前结核病消除策略的一部分。除了医学风险外，没有其他特定标准来指定哪些群体为发展结核病的高风险人群。我们假设，如果在基因型聚集的结核分枝杆菌感染者所在社区进行基于地点的筛查，那么近期传播感染且未被诊断出结核病的LTBI患者就可以被识别出来。
与多个社区组织合作，利用先前用于其他类型筛查的资源进行基于地点的结核病筛查。
基于地点的筛查每筛查83人可发现1例结核病患者，每筛查5人可发现1例LTBI患者。在一个结核病发病率为每10万人5.7例的县，这种针对性筛查计划发现结核病和LTBI患者的检出率超过了非针对性筛查的预期。
基因分型与地理信息系统分析相结合有可能用于定义高风险状态并确定基于地点的结核病筛查区域。
