Ho Jennifer, Fox Greg J, Marais Ben J
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, Australia; Centre for Research Excellence in Tuberculosis (TB-CRE) and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia.
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Centre for Research Excellence in Tuberculosis (TB-CRE) and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.
Int J Mycobacteriol. 2016 Dec;5(4):374-378. doi: 10.1016/j.ijmyco.2016.09.023. Epub 2016 Oct 28.
Current World Health Organisation targets calling for an end to the global tuberculosis (TB) epidemic by 2035 require a dramatic improvement in current case-detection strategies. A reliance on passive case finding (PCF) has resulted consistently, in over three million infectious TB cases per year, being missed by the health system, leading to ongoing transmission of infection within families and communities. Active case finding (ACF) for TB has been recognized as an important complementary strategy to PCF, in order to diagnose and treat patients earlier, reducing the period of infectiousness and therefore transmission. ACF may also achieve substantial population-level TB control. Local TB epidemiology and the resources available in each setting will influence which populations should be screened, and the types of ACF interventions to use for maximal impact. TB control programs should begin with the highest risk groups and broaden their activities as resources allow. Mathematical models can help to predict the population-level effects and the cost-effectiveness of a variety of ACF strategies on different risk populations.
世界卫生组织当前的目标是到2035年结束全球结核病流行，这需要对当前的病例检测策略进行大幅改进。依赖被动病例发现（PCF）导致卫生系统每年始终漏诊超过300万例传染性结核病病例，从而导致家庭和社区内感染的持续传播。结核病的主动病例发现（ACF）已被视为PCF的一项重要补充策略，以便更早地诊断和治疗患者，缩短传染期，从而减少传播。ACF还可能在人群层面实现实质性的结核病控制。当地的结核病流行病学情况以及每个地区可用的资源将影响应筛查哪些人群，以及为实现最大影响而采用的ACF干预措施类型。结核病控制项目应从风险最高的群体开始，并在资源允许的情况下扩大其活动范围。数学模型有助于预测各种ACF策略对不同风险人群的人群层面影响和成本效益。
