Verdier Jesse Eduard, Jan de Vlas Sake, Kidgell-Koppelaar Inge D, Richardus Jan Hendrik
Department of Public Health, Erasmus MC, University Medical Center Rotterdam; ; Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands.
Department of Public Health, Erasmus MC, University Medical Center Rotterdam;
Infect Dis Rep. 2012 Apr 3;4(2):e26. doi: 10.4081/idr.2012.e26. eCollection 2012 Apr 27.
Contact investigations around tuberculosis patients enable early detection of infection and disease, and prevention of secondary tuberculosis cases. We aim to identify risk factors for M. tuberculosis transmission to contacts of tuberculosis patients, based on unique data from routine contact investigations by the Public Health Service in Rotterdam, the Netherlands, collected between 2001 and 2006. Through logistic regression analysis, we determined the effect of various risk factors on the chance of finding a latent tuberculosis (TB) infection or overt tuberculosis case among contacts. A total of 1165 index patients with active tuberculosis were registered and at least one contact was investigated in 731, resulting in 21,540 contacts overall. Altogether, the contact investigations led to 91 cases of active tuberculosis. Of the 12,698 contacts eligible for screening by tuberculin skin test, 1091 (9%) were diagnosed with latent tuberculosis infections. Risk factors were old age of the contact, old age of the index patient, and the relationship to the index. A larger fraction of infected close contacts was strongly associated with infections among more distant contacts. Our findings emphasize the importance of including these personal and interpersonal risk factors in decision making in contact investigations.
对结核病患者进行接触者调查有助于早期发现感染和疾病，并预防继发性结核病例。我们旨在根据荷兰鹿特丹公共卫生服务机构在2001年至2006年期间进行的常规接触者调查的独特数据，确定结核分枝杆菌传播给结核病患者接触者的风险因素。通过逻辑回归分析，我们确定了各种风险因素对在接触者中发现潜伏性结核感染或显性结核病例几率的影响。总共登记了1165例活动性结核病患者，其中731例至少有一名接触者接受了调查，总共涉及21540名接触者。接触者调查共发现91例活动性结核病例。在12698名有资格接受结核菌素皮肤试验筛查的接触者中，1091人（9%）被诊断为潜伏性结核感染。风险因素包括接触者年龄较大、指示病例年龄较大以及与指示病例的关系。感染的密切接触者比例较高与较远接触者中的感染密切相关。我们的研究结果强调了在接触者调查决策中纳入这些个人和人际风险因素的重要性。
