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革新结核病控制策略:预防性治疗以实现消除结核病。

Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination.

机构信息

University Medical Hospital Schleswig-Holstein, Member of the German Center for Lung Research, DZL, Kiel.

出版信息

Eur Respir J. 2013 Sep;42(3):785-801. doi: 10.1183/09031936.00205512. Epub 2013 Feb 8.

Abstract

The introduction of new rapid diagnostic tools for tuberculosis (TB) and the promising TB drugs pipeline together with the development of a new World Health Organization Strategy post 2015 allows new discussions on how to direct TB control. The European Respiratory Society's European Forum for TB Innovation was created to stimulate discussion on how to best take advantage of old and new opportunities, and advances, to improve TB control and eventually progress towards the elimination of TB. While TB control is aimed at reducing the incidence of TB by early diagnosis and treatment of infectious cases of TB, TB elimination requires focus on sterilising the pool of latently infected individuals, from which future TB cases would be generated. This manuscript describes the three core components that are necessary to implement the elimination strategy fully. 1) Improve diagnosis of latent TB infected individuals. 2) Improve regimens to treat latent TB infection. 3) ensure public health commitment to make both 1) and 2) possible. Old and new evidence is critically described, focusing on the European commitment to reach elimination and on the innovative experiences and best practices available.

摘要

引入新的快速诊断工具来诊断结核病(TB)和前景广阔的结核病药物研发管线,以及 2015 年后世界卫生组织新战略的制定,为如何指导结核病控制提供了新的讨论方向。欧洲呼吸学会的结核病创新欧洲论坛旨在激发讨论,探讨如何充分利用旧的和新的机会和进展,以改善结核病控制,并最终朝着消除结核病的方向前进。虽然结核病控制的目标是通过早期诊断和治疗传染性结核病病例来降低结核病的发病率,但要消除结核病,就必须集中精力对潜伏性感染个体进行杀菌,这些个体是未来结核病病例的来源。本文描述了实施消除策略所需的三个核心组成部分。1)改善潜伏性结核病感染者的诊断。2)改善治疗潜伏性结核病感染的方案。3)确保公共卫生部门的承诺,使 1)和 2)成为可能。批判性地描述了新旧证据,重点是欧洲为实现消除结核病的目标而做出的承诺,以及现有的创新经验和最佳实践。

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