Jiménez-Fuentes M A, Augé C Milà, Gómez M N Altet, Peiró J Solsona, de Souza Galvao M L, Maldonado J, Molina-Pinargote I, Orcau A, Cayla J A
Special Program on Infectious Diseases, Tuberculosis Unit, Vall d'Hebrón-Drassanes, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
Directly Observed Treatment Unit, Serveis Clínics, Barcelona, Spain.
Int J Tuberc Lung Dis. 2014 Dec;18(12):1459-65. doi: 10.5588/ijtld.14.0271.
To evaluate an active case-finding strategy among drug users (DUs), economically disadvantaged individuals and recent immigrants from hyperendemic countries, a population at high risk of developing tuberculosis (TB).
Retrospective, observational study carried out by the Tuberculosis Unit of the City of Barcelona from September 2009 to December 2012. All participants underwent chest X-ray and were screened for symptoms.
Of 5982 participants screened, 30 TB cases were detected (total prevalence 0.5%): 26 were pulmonary, 8 were smear-positive and 2 were resistant to multiple drugs. Directly observed treatment was advised for 19 patients (63%). TB prevalence in the recent immigrants group was significantly greater (1.77%) than in all other groups studied: economically disadvantaged individuals 0.30% (RR 5.9, 95%CI 2.30-15.14); DUs 0.62% (RR 2.05, 95%CI 0.91-4.64), non-recent immigrants 0.41% (RR 4.31, 95%CI 1.68-11.4); and all native-born individuals 0.41% (RR 4.33, 95%CI 1.71-10.92). The rate was much greater than the estimated prevalence for the general population of the city (∼20 cases/100,000 population).
In high-risk groups, active case finding can be used as a public health intervention to detect a large number of TB cases.
评估针对吸毒者、经济弱势群体以及来自结核病高流行国家的新移民开展的主动病例发现策略，这些人群是结核病（TB）的高危人群。
巴塞罗那市结核病防治单位于2009年9月至2012年12月开展的回顾性观察研究。所有参与者均接受胸部X光检查并进行症状筛查。
在5982名接受筛查的参与者中，共检测出30例结核病病例（总患病率0.5%）：26例为肺结核，8例痰涂片阳性，2例对多种药物耐药。建议对19名患者（63%）进行直接观察治疗。新移民组的结核病患病率（1.77%）显著高于所有其他研究组：经济弱势群体为0.30%（相对风险5.9，95%置信区间2.30 - 15.14）；吸毒者为0.62%（相对风险2.05，95%置信区间0.91 - 4.64），非新移民为0.41%（相对风险4.31，95%置信区间1.68 - 11.4）；所有本地出生者为0.41%（相对风险4.33，95%置信区间1.71 - 10.92）。该患病率远高于该市普通人群的估计患病率（约20例/10万人口）。
在高危人群中，主动病例发现可作为一种公共卫生干预措施，用于发现大量结核病病例。
