Lee M S-N, Leung C-C, Kam K-M, Wong M-Y, Leung M C-M, Tam C-M, Leung E C-C
Tuberculosis and Chest Service, Public Health Service Branch, Centre of Health Protection, Department of Health, Hong Kong, China.
Int J Tuberc Lung Dis. 2008 Mar;12(3):281-7.
Tuberculosis (TB) notification is a statutory requirement in Hong Kong, where contact investigations are performed by the Tuberculosis and Chest Service.
The characteristics of consecutive TB cases notified from 18 January to 17 April 2000 were collected together with those of their contacts. Contacts were prospectively followed up through the territory-wide TB notification registry for 5 years for the development of disease.
A total of 1537 index cases and 4661 close contacts were analysed. Screening found 31 (0.67%) active TB cases within a 3-month period, and another 58 (1.24%) cases presented subsequently. Index cases with cough or pulmonary cavities and diabetic contacts were independent risk factors of early cases (all P<0.05). Adjusted at risk index characteristics for late TB development included positive sputum smear (2.79, 95%CI 1.31-5.95) and family history of TB (4.26, 95%CI 2.01-9.03). Contact risk factors included diabetes mellitus (3.44, 95%CI 1.04-11.33) and institutionalisation (3.61, 95%CI 1.70-7.65).
Considerable TB risk remains after initial contact screening. A number of possible risk factors were identified.
在香港，结核病（TB）通报是一项法定要求，结核病防治服务部门负责进行接触者调查。
1）评估5年内密切接触者发生活动性结核病的风险，以及2）确定与活动性结核病早期和晚期发病相关的风险因素。
收集了2000年1月18日至4月17日通报的连续结核病病例及其接触者的特征。通过全港结核病通报登记册对接触者进行了为期5年的前瞻性随访，以观察疾病的发生情况。
共分析了1537例索引病例和4661名密切接触者。筛查发现3个月内有31例（0.67%）活动性结核病病例，随后又有58例（1.24%）病例出现。有咳嗽或肺空洞的索引病例以及糖尿病接触者是早期病例的独立危险因素（均P<0.05）。调整后的晚期结核病发病风险指数特征包括痰涂片阳性（2.79，95%CI 1.31 - 5.95）和结核病家族史（4.26，95%CI 2.01 - 9.03）。接触者的危险因素包括糖尿病（3.44，95%CI 1.04 - 11.33）和机构收容（3.61，95%CI 1.70 - 7.65）。
初次接触者筛查后仍存在相当大的结核病风险。确定了一些可能的危险因素。
