University of East Anglia, Norwich, UK.
Lancet Infect Dis. 2010 Mar;10(3):176-83. doi: 10.1016/S1473-3099(10)70028-1.
WHO international guidelines for the control of tuberculosis in relation to air travel require-after a risk assessment-tracing of passengers who sat for longer than 8 h in rows adjacent to people with pulmonary tuberculosis who are smear positive or smear negative. A further recommendation is that all commercial air travel should be prohibited until the person has two consecutive negative sputum smears for drug-susceptible tuberculosis or two consecutive cultures for multidrug-resistant tuberculosis. In this Review I examine the evidence put forward to support these recommendations and assess whether such an approach is justifiable. A systematic review identified 39 studies of which 13 were included. The majority of studies found no evidence of transmission. Only two studies reported reliable evidence of transmission. The analysis suggests that there is reason to doubt the value of actively screening air passengers for infection with Mycobacterium tuberculosis and that the resources used might be better spent addressing other priorities for the control of tuberculosis.
世界卫生组织有关结核病与航空旅行的国际指南要求——在风险评估之后——对与涂阳或涂阴肺结核患者相邻而坐超过 8 小时的旅客进行追踪。还有一项建议是，所有商业航空旅行都应禁止，直到该人连续两次痰培养阴性（药物敏感性结核病）或连续两次培养（耐多药结核病）。在这篇综述中，我研究了支持这些建议的证据，并评估了这种方法是否合理。一项系统评价确定了 39 项研究，其中 13 项被纳入。大多数研究没有发现传播的证据。只有两项研究报告了可靠的传播证据。分析表明，有理由怀疑主动筛查航空旅客是否感染结核分枝杆菌的价值，而且所使用的资源可能更好地用于解决结核病控制的其他优先事项。
