Ratovoson Rila, Raharimanga Voamalala, Rakotosamimanana Niaina, Ravaloson B, Ratsitorahina Maherisosa, Randremanana Rindra, Ramarokoto Herimanana, Rajatonirina Soatiana, Rasolofo Voahangy, Richard Vincent
Epidemiology Unit, Pasteur Institute in Antananarivo, Antananarivo, Madagascar.
Mycobacteria Unit, Pasteur Institute in Antananarivo, Antananarivo, Madagascar.
PLoS One. 2014 Apr 17;9(4):e95494. doi: 10.1371/journal.pone.0095494. eCollection 2014.
Tuberculosis continues to cause unacceptably high levels of disease and death worldwide. Active preventive strategies are required to improve tuberculosis control and to increase the number of cases treated in developing countries. The aim of this study was to evaluate the utility of the tuberculin skin test (TST) in first-year schoolchildren as a means of increasing the number of tuberculosis cases detected through the screening of close contacts.
All members of the households of 90 schoolchildren assigned to three groups on the basis of TST category (≤ 5 mm, [5-15)mm, ≥ 15 mm) were screened for sputum smear-positive pulmonary tuberculosis. The percentage detection of tuberculosis in close contacts was compared between TST categories.
We identified 433 close contacts of the 90 schoolchildren, who were then evaluated for tuberculosis. We identified 11 cases of pulmonary tuberculosis among the close contacts (7 already on treatment and 4 previously undiagnosed): 0 in TST category ≤ 5 mm, 3 in TST category [5-15) mm and 8 in TST category ≥ 15 mm). This approach increased the detection of tuberculosis cases by a factor of 1.6 in first-year schoolchildren of the TST ≥ 5 mm group.
TST in first-year schoolchildren is a potentially effective method for improving the detection of tuberculosis in close contacts.
在全球范围内，结核病持续导致高得令人无法接受的发病率和死亡率。需要采取积极的预防策略来改善结核病控制，并增加发展中国家接受治疗的病例数量。本研究的目的是评估结核菌素皮肤试验（TST）在一年级学童中的效用，以此作为通过筛查密切接触者来增加结核病病例发现数量的一种手段。
根据TST结果（≤5mm、[5 - 15)mm、≥15mm）将90名学童分为三组，对其家庭中的所有成员进行痰涂片阳性肺结核筛查。比较不同TST结果组中密切接触者的结核病检出率。
我们确定了90名学童的433名密切接触者，并对他们进行了结核病评估。在密切接触者中我们发现了11例肺结核病例（7例已在治疗中，4例先前未被诊断）：TST结果≤5mm组中为0例，TST结果[5 - 15)mm组中为3例，TST结果≥15mm组中为8例。这种方法使TST≥5mm组的一年级学童中结核病病例的检出率提高了1.6倍。
一年级学童的TST是一种潜在有效的方法，可用于改善密切接触者中结核病的检出情况。
