United States Agency for International Development, Washington, DC, USA.
Int J Tuberc Lung Dis. 2017 Nov 1;21(11):1101-1113. doi: 10.5588/ijtld.17.0271.
Finding the missing 4 million tuberculosis (TB) patients is one of the greatest challenges facing the TB community. The optimal approaches to this will vary by country, but there is no consistent process for analyzing the potential benefit of different strategies, or for deciding which approaches are most appropriate for a given setting. Here, I bring together the Onion Model-as a way to think through health system structures-and evidence from prevalence surveys. The result is a structured process for prioritizing different strategies for case finding. Outcomes vary widely by setting, pointing to the importance of each country undertaking such a prioritization process.
发现缺失的 400 万结核病（TB）患者是结核病防治工作者面临的最大挑战之一。但各国面临的情况不同，因此最优的方法也各不相同。目前还没有一种一致的方法来分析不同策略的潜在收益，也没有一种方法可以决定哪种方法最适合特定的环境。在这里，我将洋葱模型（Onion Model）——一种思考卫生系统结构的方法——与流行率调查的证据相结合，为确定不同病例发现策略的优先级提供了一个结构化的流程。不同环境下的结果差异很大，这表明每个国家都必须进行这样的优先级排序过程。
