Abramson O, Rosenvasser Z, Block C, Dagan R
Rahat Clinic, Sheba Medical Center, Tel Hashomer, Israel.
Pediatr Infect Dis J. 1991 Jun;10(6):434-8. doi: 10.1097/00006454-199106000-00003.
Brucellosis presents a difficult diagnostic challenge in view of its protean manifestations, multiple organ involvement and variable clinical course. The purpose of the present study was to determine whether active screening of a population at risk, identified through index cases, would enhance the detection rate of brucellosis and improve treatment. During a 1-month period all 98 individuals sharing risk factors with 4 diagnosed symptomatic cases of brucellosis in one Bedouin town in southern Israel were approached and 86 agreed to undergo screening. Symptomatic brucellosis was found in 8 (9%) of the screened population and an additional 5 (6%) asymptomatic individuals were found to be seropositive. These 13 were followed for 12 months. All symptomatic cases were treated and cured. Of the 5 asymptomatic seropositive individuals 2 showed a further elevation of Brucella antibody titers. One became symptomatic, was treated and was cured. This screening program provided 53% of all reported cases from the Bedouin town during the entire year of the study. Screening a population at risk increased the detection rate of brucellosis and improved the treatment.
鉴于布鲁氏菌病临床表现多样、累及多个器官且临床病程多变，其诊断颇具挑战。本研究旨在确定通过索引病例识别出的高危人群进行主动筛查是否会提高布鲁氏菌病的检出率并改善治疗效果。在1个月的时间里，研究人员对以色列南部一个贝都因城镇中与4例已确诊的布鲁氏菌病症状性病例有共同危险因素的所有98人进行了接触，其中86人同意接受筛查。在接受筛查的人群中，有8人（9%）被发现患有症状性布鲁氏菌病，另有5人（6%）无症状个体血清学检测呈阳性。对这13人进行了为期12个月的随访。所有症状性病例均接受治疗并治愈。在5例无症状血清学阳性个体中，2例布鲁氏菌抗体滴度进一步升高。1例出现症状，接受治疗并治愈。在本研究的一整年中，该筛查项目提供了来自该贝都因城镇所有报告病例的53%。对高危人群进行筛查提高了布鲁氏菌病的检出率并改善了治疗效果。
