Malacarne Jocieli, Rios Diana Patricia Giraldo, Silva Cosme Marcelo Furtado Passos da, Braga José Ueleres, Camacho Luiz Antonio Bastos, Basta Paulo Cesar
Programa de Pós-Graduação Stricto Sensu em Epidemiologia em Saúde Pública, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
Rev Soc Bras Med Trop. 2016 Jul-Aug;49(4):456-64. doi: 10.1590/0037-8682-0220-2016.
Recent studies have shown a high incidence and prevalence of latent tuberculosis infection (LTBI) in indigenous populations around the World. We aimed to estimate the prevalence and annual risk of infection (ARI) as well as to identify factors associated with LTBI in an indigenous population from the Brazilian Amazon.
We conducted a cross-sectional study in 2011. We performed tuberculin skin tests (TSTs), smears and cultures of sputum samples, and chest radiographs for individuals who reported cough for two or more weeks. Associations between LTBI (TST ≥5mm) and socio-demographic, clinical, and epidemiological characteristics were investigated using Poisson regression with robust variance. Prevalence ratio (PR) was used as the measure of association.
We examined 263 individuals. The prevalence of LTBI was 40.3%, and the ARI was 2.4%. Age ≥15 years [PR=5.5; 95% confidence interval (CI): 3.5-8.6], contact with tuberculosis (TB) patients (PR=3.8; 95% CI: 1.2-11.9), previous TB history (PR=1.4; 95% CI: 1.2-1.7), and presence of Bacillus Calmette-Guérin (BCG) scar (PR=1.9, 95% CI: 1.2-2.9) were associated with LTBI.
Although some adults may have been infected years prior, the high prevalence of infection and its strong association with age ≥15 years, history of TB, and recent contact with TB patients suggest that the TB transmission risk is high in the study area.
近期研究表明，全球土著人群中潜伏性结核感染（LTBI）的发病率和患病率较高。我们旨在估算巴西亚马逊地区一个土著人群中LTBI的患病率和年度感染风险（ARI），并确定与LTBI相关的因素。
我们在2011年开展了一项横断面研究。对报告咳嗽持续两周或更长时间的个体进行结核菌素皮肤试验（TST）、痰标本涂片和培养以及胸部X光检查。使用具有稳健方差的泊松回归研究LTBI（TST≥5mm）与社会人口统计学、临床和流行病学特征之间的关联。患病率比（PR）用作关联度量。
我们检查了263名个体。LTBI的患病率为40.3%，ARI为2.4%。年龄≥15岁[PR = 5.5；95%置信区间（CI）：3.5 - 8.6]、与结核病（TB）患者接触（PR = 3.8；95% CI：1.2 - 11.9）、既往TB病史（PR = 1.4；95% CI：1.2 - 1.7）以及存在卡介苗（BCG）瘢痕（PR = 1.9，95% CI：1.2 - 2.9）与LTBI相关。
尽管一些成年人可能在数年前就已感染，但感染的高患病率及其与年龄≥15岁、TB病史以及近期与TB患者接触之间的强关联表明，研究地区的TB传播风险很高。
