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[中国上海非户籍人口中结核病患者密切接触者潜伏性结核感染的患病率及危险因素]

[Prevalence and risk factors of latent tuberculosis infection in close contacts of tuberculosis patients among non-resident populations in Shanghai, China].

作者信息

Xu Jiangjun, Hu Yi, Jiang Weili, Hong Jianjun, Tang Lihong, Yang Meixia, Shen Xin, Xu Biao

机构信息

Department of Epidemiology, School of Public Health, Fudan University, the Key Laboratory on Public Health Safety Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Shanghai 200032, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2016 Jan;39(1):25-9. doi: 10.3760/cma.j.issn.1001-0939.2016.01.008.

Abstract

OBJECTIVE

To investigate the prevalence of latent tuberculosis (TB) infection (LTBI), and to identify the risk factors in close contacts of pulmonary TB patients among non-resident population in Shanghai.

METHODS

The study subjects were the close contacts of pulmonary TB patients among non-resident populations in Xuhui, Minhang and Songjiang Districts in Shanghai from 2013 to 2014.Questionnaire interview was applied to collect the socio-demographics, TB-related clinical and TB exposure information from the enrolled TB patients and their close contacts. The T-SPOT.TB test was used to identify the infection of M. TB. LTBI was defined as a positive T-SPOT.TB result inthe absence of signs and symptoms related to TB.

RESULTS

In total, 182 pulmonary TB patients and 360 close contacts were enrolled in the present study. The mean age of the close contacts was (34±14) years(range, 2-83 years), including 160 men and 200 women. The T-SPOT.TB test and TB related examination revealed that 17.2% (62/360) of the close contacts were latently infected with M. TB. All the LTBI subjects were household contacts (χ(2)=16.814, P<0.001). In multivariate analysis, the risk of LTBI was statistically associated with the presence of TB symptoms of the index case (OR=2.696, 95%CI: 1.060-6.857) and duration of exposure (OR=1.007, 95%CI: 1.001-1.014); whereas there were no statistically significant associations among age, gender, diagnostic delay of index case, environment of contact place and the risk of LTBI among the studied close contacts.

CONCLUSIONS

The prevalence of LTBI in close contacts of pulmonary TB patients among non-resident population in Shanghai is 17.2%.Contact with patients with TB symptoms and longer duration of exposure might increase the risk of LTBI.

摘要

目的

调查上海市非户籍人口中潜伏性结核感染(LTBI)的患病率,并确定肺结核患者密切接触者中的危险因素。

方法

研究对象为2013年至2014年上海市徐汇区、闵行区和松江区非户籍人口中肺结核患者的密切接触者。采用问卷调查的方式收集入选肺结核患者及其密切接触者的社会人口学信息、结核病相关临床信息和结核病暴露信息。采用T-SPOT.TB检测来确定结核分枝杆菌感染情况。LTBI定义为T-SPOT.TB检测结果为阳性且无结核病相关体征和症状。

结果

本研究共纳入182例肺结核患者和360名密切接触者。密切接触者的平均年龄为(34±14)岁(范围为2至83岁),其中男性160名,女性200名。T-SPOT.TB检测及结核病相关检查显示,17.2%(62/360)的密切接触者潜伏感染结核分枝杆菌。所有LTBI受试者均为家庭接触者(χ(2)=16.814,P<0.001)。多因素分析显示,LTBI风险与指示病例的结核病症状(OR=2.696,95%CI:1.060-6.857)及接触持续时间(OR=1.007,95%CI:1.001-1.014)具有统计学关联;而在研究的密切接触者中,年龄、性别、指示病例的诊断延迟、接触场所环境与LTBI风险之间无统计学显著关联。

结论

上海市非户籍人口中肺结核患者密切接触者的LTBI患病率为17.2%。与有结核病症状的患者接触以及较长的接触持续时间可能会增加LTBI风险。

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