Brant L J, Bender T R, Bross D S
Prev Med. 1986 Nov;15(6):632-42. doi: 10.1016/0091-7435(86)90068-x.
Prospective follow-up information from the throat culturing results of 1,653 Eskimo children in 12 Alaskan villages was used to evaluate the effect of duration and intensity of a streptococcal control program begun in 1971 while controlling for several other risk factors related to streptococcal colonization. Relative risks of colonization for each of the subsequent study years relative to the first year indicate that the risk of colonization decreased over the duration of the study by 42% in Year 2 to 55% in Year 4 (P less than 0.0001). Cost-cutting measures such as lengthening the time interval between routine throat cultures led to a 37% increase in the risk of colonization (P = 0.0002). A comparison of the number of cases of acute rheumatic fever during the 5-year period before the streptococcal control program with the number of cases during the 5-year program period showed that cases in villages with the program decreased from 11 to 0. In a similar group of comparison villages without the program, the number of cases decreased from 7 to 4. A benefit-cost study of the program indicates that benefit exceeds cost. These findings and the changes in the carriage of streptococcal organisms during the control program underscore the importance of such long-term programs with regularly scheduled culturing in high-risk populations of children.
来自阿拉斯加12个村庄的1653名爱斯基摩儿童咽喉培养结果的前瞻性随访信息，被用于评估始于1971年的链球菌控制项目的持续时间和强度的效果，同时控制其他一些与链球菌定植相关的风险因素。相对于第一年，随后各研究年份定植的相对风险表明，在研究期间，定植风险在第2年下降了42%，在第4年下降了55%（P小于0.0001）。诸如延长常规咽喉培养之间的时间间隔等成本削减措施导致定植风险增加了37%（P = 0.0002）。将链球菌控制项目实施前5年期间急性风湿热病例数与项目实施5年期间的病例数进行比较，结果显示，实施该项目村庄的病例数从11例降至0例。在一组类似的未实施该项目的对照村庄中，病例数从7例降至4例。该项目的效益成本研究表明效益超过成本。这些发现以及控制项目期间链球菌携带情况的变化，凸显了在高危儿童群体中开展定期培养的此类长期项目的重要性。
