Tuberculosis Section, Respiratory Diseases Department, Health Protection Agency, Colindale, London, UK.
Int J Tuberc Lung Dis. 2013 May;17(5):573-82. doi: 10.5588/ijtld.12.0920.
In low-incidence countries, tuberculosis (TB) is now largely concentrated in high-risk groups such as migrants, homeless people, illicit drug users, alcoholics and prisoners. This has led to increased efforts to implement targeted active case finding for TB among specific populations. This review examines the evidence supporting active case finding in migrants and social risk groups, as well as the cost-effectiveness of interventions. While data from observational studies support active case finding in defined high-risk groups, further research to determine the effectiveness of specific tools and the cost-effectiveness of screening strategies is needed to inform evidence-based control methods in low-incidence countries. Inevitably, addressing TB in low-incidence countries will depend on effective disease control in high-burden countries.
在低发病国家，结核病（TB）现在主要集中在高危人群中，如移民、无家可归者、非法药物使用者、酗酒者和囚犯。这导致了更多的努力来针对特定人群实施结核病的主动病例发现。本综述考察了支持在移民和社会风险群体中开展主动病例发现的证据，以及干预措施的成本效益。虽然来自观察性研究的数据支持在明确的高风险群体中开展主动病例发现，但需要进一步研究来确定特定工具的有效性和筛查策略的成本效益，以便为低发病国家提供基于证据的控制方法。不可避免的是，在低发病国家解决结核病问题将取决于高负担国家的有效疾病控制。
