Izumi K, Ohkado A, Uchimura K, Kawatsu L, Suenaga M, Urakawa M, Kato S
Department of Epidemiology and Clinical Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (RIT/JATA), Tokyo, Japan; Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Department of Epidemiology and Clinical Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (RIT/JATA), Tokyo, Japan.
Int J Tuberc Lung Dis. 2017 Feb 1;21(2):188-195. doi: 10.5588/ijtld.16.0508.
Although monitoring and evaluation using standardised indicators is an important aspect of tuberculosis (TB) contact investigation, no attempts have been made to systematically evaluate contact investigations in Japan.
To evaluate TB contact investigations conducted in public health centres (PHCs) by estimating the scores of selected indicators.
A cross-sectional study was conducted in 2012 to estimate six selected indicator scores for contact tracing, contact evaluation and contact treatment at 11 PHCs using the TB registry and relevant contact investigation records of all forms of newly notified active TB cases. Indicator scores were compared across PHCs using median and interquartile range (IQR).
A total of 2527 contacts of 313 index TB cases were identified; of these, 1874 were evaluated using the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs). Of 187 contacts who were TST/IGRA-positive, 15 were diagnosed with active TB. Consistently higher medians and lower IQRs were obtained for indicators of contact tracing and contact evaluation than those of contact treatment.
Our study is the first to evaluate the performance of TB contact investigations in Japan using standardised indicators; the study indicated performance gaps, especially in the treatment for latent tuberculous infection among contacts.
尽管使用标准化指标进行监测和评估是结核病（TB）接触者调查的一个重要方面，但日本尚未尝试对接触者调查进行系统评估。
通过估计选定指标的得分来评估在公共卫生中心（PHC）开展的结核病接触者调查。
2012年进行了一项横断面研究，利用结核病登记册和所有新报告的活动性结核病病例的相关接触者调查记录，对11个公共卫生中心在接触者追踪、接触者评估和接触者治疗方面的6个选定指标得分进行估计。使用中位数和四分位数间距（IQR）对各公共卫生中心的指标得分进行比较。
共识别出313例结核病索引病例的2527名接触者；其中，1874名接触者接受了结核菌素皮肤试验（TST）或干扰素-γ释放试验（IGRA）评估。在187名TST/IGRA阳性的接触者中，15名被诊断为活动性结核病。接触者追踪和接触者评估指标的中位数始终高于接触者治疗指标，四分位数间距则更低。
我们的研究首次使用标准化指标评估了日本结核病接触者调查的表现；该研究表明存在表现差距，尤其是在接触者潜伏结核感染的治疗方面。
