Birmingham East and North Primary Care Trust, Birmingham, United Kingdom.
Euro Surveill. 2010 Mar 18;15(11):19510.
To quantify the risk of developing tuberculosis (TB) following school contact with a student with smear positive respiratory TB in a population with a high background rate of tuberculosis, a retrospective cohort study was conducted. This study included all students and staff (n=1,065) at an inner city secondary school in Birmingham, United Kingdom (UK). Being in the same school year as the index case resulted in a significantly higher risk of being diagnosed with active TB (odds ratio (OR) 6.11) and either active or latent TB (OR 10.52) compared to the risk for pupils in other school years. Neither lower level classroom exposure in tutoring groups nor being a staff member resulted in significantly increased risk of infection. The number of cases detected in the school was significantly higher than compared with the TB notification rate for the respective age groups in the population in the area. This study is consistent with the small body of evidence that already exists suggesting that greater levels of classroom contact with a student with smear positive active TB significantly increases the risk of contracting active and latent TB. It also suggests that staff may be at a lower risk of active TB than students. It does not appear that being in an area with high TB incidence substantially alters the epidemiology of the outbreak or risk of transmission between students in comparison to other populations.
为了量化在结核高背景率人群中，与涂片阳性呼吸道结核学生接触后发生结核的风险，进行了一项回顾性队列研究。该研究纳入了英国伯明翰市一所市中心中学的所有学生和教职员工（n=1,065）。与索引病例同校年显著增加了确诊活动性结核（比值比（OR）6.11）和活动性或潜伏性结核（OR 10.52）的风险，与其他校年的学生相比。与教员相比，在辅导小组中处于较低水平的课堂接触或作为教员并未导致感染风险显著增加。在学校中检测到的病例数明显高于该地区相应年龄组人群的结核报告率。本研究与现有的少量证据一致，表明与涂片阳性活动性结核学生的课堂接触水平越高，患活动性和潜伏性结核的风险就越大。它还表明，与学生相比，教职员工患活动性结核的风险可能较低。与其他人群相比，处于结核发病率高的地区似乎并没有显著改变疫情的流行病学或学生之间的传播风险。
