英格兰西北部服务不足的结核病患者的接触者患结核病的几率更高：一项队列研究。

Contacts of underserved tuberculosis patients have higher odds of TB disease in North West England: a cohort study.

机构信息

Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, Public Health England Field Service North West, Liverpool, Tropical and Infectious Diseases Unit, Royal Liverpool Hospital, Liverpool, LIV-TB Collaboration and Department of Clinical Science, Liverpool School of Tropical Medicine, Liverpool, UK, Social Medicine, Infectious Diseases and Migration Group, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

LIV-TB Collaboration and Department of Clinical Science, Liverpool School of Tropical Medicine, Liverpool, UK, HIV/TB Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.

出版信息

Int J Tuberc Lung Dis. 2019 Mar 1;23(3):337-343. doi: 10.5588/ijtld.18.0467.

DOI:10.5588/ijtld.18.0467

PMID:30871665

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6421945/

Abstract

OBJECTIVE

To investigate the association between patients' social risk factors and the risk of tuberculous infection and TB disease among their contacts in England.

DESIGN

This was a cohort study of all TB cases from North West England diagnosed between 27 March 2012 and 28 June 2016. The social risk factors of TB cases were evaluated to estimate their need for enhanced case management (ECM), from 0 (standard of care) to 3 (intensive social support).

RESULTS

A total of 2139 cases and their 10 019 contacts met the eligibility criteria. Being a contact of a patient with smear-positive TB with high ECM or being of Black Caribbean ethnicity was independently associated with greater odds of active TB disease (smear-positive vs. smear-negative, OR 5.3, 95%CI 3.2-8.7; ECM-3 vs. ECM-0, OR 2.2, 95%CI 1.01-5.0; Black Caribbean vs. White, OR 7.4, 95%CI 2.1-25). Being a contact of a patient with smear-positive TB or of Black Caribbean ethnicity was also independently associated with greater odds of tuberculous infection (smear-positive vs. smear-negative, OR 5.3, 95%CI 3.8-7.3; and Black Caribbean vs. White, OR 6.7, 95%CI 2.0-25).

CONCLUSIONS

The social complexity and ethnicity of patients were associated with tuberculous infection and TB disease in their contacts.

摘要

目的

在英格兰，调查患者社会风险因素与接触者结核感染和结核病发病风险之间的关系。

设计

这是一项针对 2012 年 3 月 27 日至 2016 年 6 月 28 日期间在英格兰西北部诊断的所有结核病病例的队列研究。评估结核病病例的社会风险因素，以估计他们需要加强病例管理（ECM）的程度，从 0（标准护理）到 3（强化社会支持）。

结果

共有 2139 例病例及其 10019 名接触者符合入选标准。与涂片阳性且 ECM 高的患者接触或具有加勒比黑人群体的种族背景与活动性结核病发病的可能性较大独立相关（涂片阳性 vs. 涂片阴性，OR5.3，95%CI3.2-8.7；ECM-3 vs. ECM-0，OR2.2，95%CI1.01-5.0；加勒比黑人群体 vs. 白人，OR7.4，95%CI2.1-25）。与涂片阳性且 ECM 高的患者接触或具有加勒比黑人群体的种族背景也与结核感染的可能性较大独立相关（涂片阳性 vs. 涂片阴性，OR5.3，95%CI3.8-7.3；加勒比黑人群体 vs. 白人，OR6.7，95%CI2.0-25）。