Langenskiold Elisabeth, Herrmann François R, Luong B L, Rochat Thierry, Janssens Jean-Paul
Division of Pulmonary Diseases, CHUV, Lausanne, Switzerland.
Swiss Med Wkly. 2008 Feb 9;138(5-6):78-84. doi: 10.4414/smw.2008.11964.
To determine the yield of contact tracing after exposure to active tuberculosis (TB) cases in a low incidence area for TB as well as completion rate and tolerance to treatment for latent TB infection (LTBI).
Retrospective study based on a database including all patients evaluated in Geneva during contact tracing procedures; review of medical records of contacts for whom treatment of LTBI was indicated.
3582 subjects were screened over 10 years (on average 4.3 contacts per index case); 8 (0.2%) had active TB. LTBI was detected in 28% of subjects screened. Foreign origin, exposure and contagiousness of index case were predictive of LTBI. Of the 996 subjects with LTBI, files of 705 subjects followed at our centre were reviewed: treatment was indicated in 571 (81%). Side-effects led to interruption of treatment for LTBI in 32 cases (6.9% of subjects treated); 227 subjects eligible for treatment (40%) either refused or stopped treatment, or were lost to follow-up. Completion rate was 67%.
In a low-incidence environment for TB, contact tracing procedures had a very low yield for detection of active TB cases; acceptance and completion rates for LTBI therapy were in agreement with recent studies..
确定在结核病低发地区接触活动性结核病（TB）病例后接触者追踪的检出率，以及潜伏性结核感染（LTBI）的治疗完成率和耐受性。
基于一个数据库进行回顾性研究，该数据库包括在日内瓦进行接触者追踪程序期间评估的所有患者；审查指示进行LTBI治疗的接触者的病历。
在10年期间筛查了3582名受试者（每个索引病例平均有4.3名接触者）；8名（0.2%）患有活动性结核病。在筛查的受试者中，28%检测出LTBI。索引病例的外国血统、接触情况和传染性可预测LTBI。在996名LTBI患者中，审查了在我们中心随访的705名患者的档案：571名（81%）需要治疗。32例（接受治疗的受试者的6.9%）因副作用导致LTBI治疗中断；227名符合治疗条件的受试者（40%）拒绝或停止治疗，或失访。完成率为67%。
在结核病低发环境中，接触者追踪程序对活动性结核病病例的检出率非常低；LTBI治疗的接受率和完成率与近期研究一致。
