Ahiko T
Department of Public Health, Yamagata University School of Medicine, Japan.
Kekkaku. 1990 Nov;65(11):739-46.
To clarify the recent problems of family contact examination for tuberculosis, studies were conducted from August 1989 through to Mach 1990. 1) The examinations were carried out in 405 (94%) out of 431 household contacts of 119 index cases with bacillary pulmonary tuberculosis who were newly registered in 1988 in Yamagata prefecture. The contacts of smear-positive cases had a significantly higher incidence rate of active tuberculosis (4.8%) and a markedly shorter interval between discovery of the index cases and their household examinations than did the contacts of smear-negative cases (i.e. bacilli positive only on culture). 2) The study on the disease history of 129 cases with bacillary pulmonary tuberculosis, newly registered in 1988 in Yamagata, revealed that one-third of them might be have been "preventable", if the existing prevention and control methods had been effectively used. Especially, the preventable cases under 20 years of age occurred among those with inadequate family contact examinations. 3) 21 families were specially investigated because they had more than one active tuberculosis. Half of them underwent insufficient family contact examinations. It was indicated that tuberculin skin tests were necessary even to those aged 16 and above as well as to those aged 15 and below, when they were family contacts of smear-positive cases. 4) The policy and methods of family contact examination were evaluated by a mail questionnaire to 74 Health Centers in Tohoku Districts. The response rate was 95% (70/74).(ABSTRACT TRUNCATED AT 250 WORDS)
为阐明近期肺结核家庭接触者检查中存在的问题,于1989年8月至1990年3月开展了多项研究。1)对1988年在山形县新登记的119例痰菌阳性肺结核患者的431名家庭接触者中的405名(94%)进行了检查。涂片阳性病例的接触者活动性肺结核发病率显著更高(4.8%),且从发现索引病例到进行家庭检查的间隔时间明显短于涂片阴性病例(即仅培养时杆菌阳性)的接触者。2)对1988年在山形县新登记的129例痰菌阳性肺结核病例的疾病史研究表明,如果有效采用现有的预防和控制方法,其中三分之一的病例可能是“可预防的”。特别是20岁以下的可预防病例出现在家庭接触者检查不足的人群中。3)对21个有不止一例活动性肺结核的家庭进行了专门调查。其中一半家庭的家庭接触者检查不足。结果表明,对于涂片阳性病例的家庭接触者,即使是16岁及以上以及15岁及以下的人群,也有必要进行结核菌素皮肤试验。4)通过向东北地区的74个保健中心邮寄调查问卷,对家庭接触者检查的政策和方法进行了评估。回复率为95%(70/74)。(摘要截短于250字)