Mancuso James D
James D. Mancuso is with the Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD.
Am J Public Health. 2017 Jan;107(1):60-67. doi: 10.2105/AJPH.2016.303502. Epub 2016 Nov 17.
Tuberculosis (TB) has a well-established association with military populations, but the association of increased TB risk during armed conflict is less certain. This historical review focuses on the evolution of screening practices, the changing epidemiology of TB, and the risk of TB among US military service members during armed conflict from 1885 to the present. Overall, deployed soldiers were not at increased risk for TB compared with nondeployed soldiers in any of these conflicts, and the risk of TB in the US military largely reflected that of the underlying US population. Nevertheless, there are focal risk groups with higher rates of TB in the military, including prisoners of war. Although the principles of TB control in the military conform to those used in the civilian population, unique military exposures during both times of peace and of armed conflict require additional screening, surveillance, and control measures.
结核病(TB)与军人群体之间的关联已得到充分证实,但武装冲突期间结核病风险增加的关联尚不确定。本历史回顾聚焦于筛查实践的演变、结核病流行病学的变化,以及1885年至今美国武装冲突期间军人患结核病的风险。总体而言,在这些冲突中的任何一场中,与未部署的士兵相比,部署的士兵患结核病的风险并未增加,美国军队中结核病的风险在很大程度上反映了美国总体人群的风险。然而,军队中存在结核病发病率较高的重点风险群体,包括战俘。尽管军队中结核病控制的原则与平民群体所采用的原则一致,但在和平时期和武装冲突时期独特的军事暴露情况需要额外的筛查、监测和控制措施。