Su Shih-Bin, Chiu Chien-Fang, Chang Cheng-Ta, Chen Kow-Tong, Lin Ching-Yih, Guo How-Ran
Tainan Science-Based Industrial Park Clinic, Chi-Mei Medical Center, Tainan, Taiwan.
Am J Infect Control. 2007 May;35(4):254-9. doi: 10.1016/j.ajic.2006.04.211.
Pulmonary tuberculosis (TB) is prevalent in Taiwan, but it is suspected that its occurrence has been underestimated by the National TB Surveillance Program. A pre-employment health examination is mandated by law in Taiwan, providing a mechanism to assess the occurrence of TB more accurately.
A pre-employment TB screening program of an industrial park was used to evaluate the performance of the National TB Surveillance Program in Taiwan. The yields of the pre-employment TB screening, using chest radiography from July 2004 to June 2005, were compared with corresponding results of the National TB Surveillance Program.
A total of 17,105 new employees with an even gender distribution (men:women ratio, 50.2%:49.8%) underwent screening during the study period. Among the participants, 22 (128.6 per 100,000) new patients with pulmonary TB were diagnosed, and 7 (31.8%) of the patients had positive bacteriology findings. Compared with the results of the National TB Surveillance Program, the pre-employment screening had a much higher yield (128 vs. 47 per 100,000, P<.001).
The yield of the active surveillance program through mandatory screening was much higher than that of the National TB Surveillance Program, which is a passive reporting system. The results of this study highlight the need for more active TB surveillance efforts in endemic areas like Taiwan.
肺结核在台湾地区较为普遍，但怀疑其发病率被国家结核病监测计划低估。台湾法律规定进行入职前健康检查，这为更准确评估结核病发病率提供了一种机制。
利用工业园区的入职前结核病筛查计划来评估台湾地区国家结核病监测计划的成效。将2004年7月至2005年6月期间采用胸部X光进行入职前结核病筛查的检出率与国家结核病监测计划的相应结果进行比较。
在研究期间，共有17105名新员工接受了筛查，男女比例均衡（男性：女性比例为50.2%：49.8%）。在参与者中，诊断出22例（每10万人中有128.6例）新发肺结核患者，其中7例（31.8%）患者细菌学检查结果呈阳性。与国家结核病监测计划的结果相比，入职前筛查的检出率要高得多（每10万人中分别为128例和47例，P<0.001）。
通过强制筛查的主动监测计划的检出率远高于作为被动报告系统的国家结核病监测计划。本研究结果凸显了在台湾等流行地区加强结核病主动监测工作的必要性。
