评估低负担地区一年级小学生进行 24 年结核病筛查的效果。

Evaluating a 24-year tuberculosis screening in first-grade elementary schoolers in a low-burden area.

机构信息

Department of General Medicine, Venizeleion General Hospital of Heraklion, Heraklion, Greece.

Department of Paediatrics, Venizeleion General Hospital of Heraklion, Heraklion, Greece.

出版信息

Acta Paediatr. 2019 Nov;108(11):2070-2074. doi: 10.1111/apa.14829. Epub 2019 May 27.

DOI:10.1111/apa.14829

PMID:31032973

Abstract

AIM

Early diagnosis of tuberculosis infection can significantly contribute to the control of the disease. The aim of the present study was to describe the tuberculin skin test (TST) trends over a 24-year period (1990-2013) and explore the value of universal tuberculosis screening in a low-burden area.

METHODS

All first graders that underwent TST during the 24-year study period (1990-2013) on the island of Crete, Greece, were retrospectively included in the study.

RESULTS

A total of 82 402 children (92.3% of Greek nationality; 51.0% male) underwent TST, of whom 335 (0.41%, 95% CI 0.37-0.46) were found to have positive TST while 0.27% of the study population had a TST between 5 and 9 mm. The tuberculin index declined significantly between 1990-1994 and 2010-2013 (0.67 vs 0.26; RR 2.73, 95% CI 1.82-4.09; p < 0.0001). Positive TST result was significantly higher in the immigrant than the native group (0.66% vs 0.24%; RR 3.76 95%, CI 2.89-4.84; p < 0.0001). In the last study years, 386 children (488 native; 153 immigrant) should be tested for one to be found TST positive.

CONCLUSION

Our findings question the massive tuberculin testing in low-burden areas and point to selective screening of high-risk groups.

摘要

目的

早期诊断结核感染可显著有助于控制该疾病。本研究旨在描述 24 年间（1990-2013 年）结核菌素皮肤试验（TST）的趋势，并探讨在低负担地区进行普遍结核筛查的价值。

方法

回顾性纳入希腊克里特岛在 24 年研究期间（1990-2013 年）接受 TST 的所有一年级学生。

结果

共 82402 名儿童（92.3%为希腊人；51.0%为男性）接受了 TST，其中 335 名（0.41%，95%CI 0.37-0.46）TST 阳性，而研究人群中 0.27%的 TST 介于 5-9mm。1990-1994 年与 2010-2013 年之间，结核菌素指数显著下降（0.67 比 0.26；RR 2.73，95%CI 1.82-4.09；p<0.0001）。移民组的 TST 阳性结果显著高于本地组（0.66%比 0.24%；RR 3.76，95%CI 2.89-4.84；p<0.0001）。在最后几年的研究中，需要对 386 名儿童（488 名本地儿童；153 名移民儿童）进行 TST 检测，才能发现 1 例阳性。