Yuen Courtney M, Amanullah Farhana, Dharmadhikari Ashwin, Nardell Edward A, Seddon James A, Vasilyeva Irina, Zhao Yanlin, Keshavjee Salmaan, Becerra Mercedes C
Brigham and Women's Hospital, Boston, MA, USA.
Indus Hospital Research Center, Karachi, Pakistan.
Lancet. 2015 Dec 5;386(10010):2334-43. doi: 10.1016/S0140-6736(15)00322-0. Epub 2015 Nov 4.
To halt the global tuberculosis epidemic, transmission must be stopped to prevent new infections and new cases. Identification of individuals with tuberculosis and prompt initiation of effective treatment to rapidly render them non-infectious is crucial to this task. However, in settings of high tuberculosis burden, active case-finding is often not implemented, resulting in long delays in diagnosis and treatment. A range of strategies to find cases and ensure prompt and correct treatment have been shown to be effective in high tuberculosis-burden settings. The population-level effect of targeted active case-finding on reducing tuberculosis incidence has been shown by studies and projected by mathematical modelling. The inclusion of targeted active case-finding in a comprehensive epidemic-control strategy for tuberculosis should contribute substantially to a decrease in tuberculosis incidence.
为阻止全球结核病流行,必须阻断传播以预防新的感染和新发病例。识别结核病患者并迅速启动有效治疗,使其尽快不再具有传染性,对于这项任务至关重要。然而,在结核病负担较重的地区,主动病例发现往往未得到实施,导致诊断和治疗出现长时间延误。一系列发现病例并确保及时、正确治疗的策略已被证明在结核病高负担地区有效。研究已证实并通过数学模型预测了针对性主动病例发现在降低结核病发病率方面的人群水平效应。将针对性主动病例发现纳入结核病综合防控策略应能大幅降低结核病发病率。