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托斯卡纳青少年结核病感染率

Prevalence of tuberculosis infection among teen-agers in Tuscany.

作者信息

Sancasciani S, Santori D, Bellugi A, Abdiaziz M A, Manzi F, Bennati D, Trezzi M, Zilianti E, Braito A

机构信息

Department of Preventive Medicine, USL 7, Siena, Italy.

出版信息

J Prev Med Hyg. 2006 Dec;47(4):151-4.

Abstract

INTRODUCTION

In Tuscany, Tuberculosis incidence is more than triplicate from 1982 to the beginning of the third millennium. The impact of this trend on open population is not known, as updated studies on Tuberculosis prevalence are not available. Tuberculin skin test provides the currently most widely used tool for assessing Tuberculosis transmission in a community and the prevalence of infection as well. The objective of this investigation was the evaluation of tuberculin index by means of the Mantoux test in adolescents eighteen-years old.

RESULTS

The study was carried out in 21 secondary schools of Siena and its Province; 1,138 students participated to this survey. The overall prevalence of subjects with a skin reaction size > 5 mm was 1.6%; if the standard cut-off of 10 mm was used, the overall prevalence of a positive skin reaction was 0.4%. Risk factors for a doubtful or positive reaction were previous immunization with BCG and migration from high-endemicity countries.

DISCUSSION

In Italy, studies on tuberculin index in young adults are scanty and controversial: our results show a very low Tuberculosis prevalence and an epidemiological pattern typical of countries with low Tuberculosis endemicity.

CONCLUSIONS

The slightly increase in Tuberculosis incidence has no impact on the prevalence of latent Tuberculosis infection on our geographical area. We conclude that skin-test screening for Tuberculosis should be addressed to high risk population as migrants from Countries reporting high transmission rate, those recently exposed to an infectious case and health-workers.

摘要

引言

在托斯卡纳,从1982年到第三个千年初,结核病发病率增长了两倍多。由于缺乏关于结核病患病率的最新研究,这种趋势对普通人群的影响尚不清楚。结核菌素皮肤试验是目前评估社区结核病传播以及感染患病率最广泛使用的工具。本调查的目的是通过曼托试验评估18岁青少年的结核菌素指数。

结果

该研究在锡耶纳及其省份的21所中学进行;1138名学生参与了此次调查。皮肤反应大小>5mm的受试者总体患病率为1.6%;如果使用10mm的标准临界值,皮肤反应阳性的总体患病率为0.4%。可疑或阳性反应的危险因素是既往接种卡介苗和来自高流行国家的移民。

讨论

在意大利,关于年轻人结核菌素指数的研究很少且存在争议:我们的结果显示结核病患病率非常低,呈现出结核病低流行国家典型的流行病学模式。

结论

结核病发病率的轻微上升对我们地理区域潜伏性结核感染的患病率没有影响。我们得出结论,结核病皮肤试验筛查应针对高危人群,如来自结核病高传播率国家的移民、最近接触过感染病例的人以及医护人员。

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