Kim Ahreum, Choi Minhyeok
Regional Center for Respiratory Diseases, Pusan National University Hospital, Busan, Korea.
J Korean Med Sci. 2019 May 13;34(18):e138. doi: 10.3346/jkms.2019.34.e138.
This study aimed to compare the indicators (the rates of diagnosis, need for treatment, treatment initiation, and treatment completion) of management of latent tuberculosis infection (LTBI) in contacts and to identify the impact of active tuberculosis (TB) index case characteristics on the exposed population in congregated settings, such as schools, workplaces, and medical institutes.
The data of 8,648 clusters in the TB epidemiological investigation database between 2013 and 2016 were extracted and analyzed to evaluate the indicators and perform multilevel logistic regression (MLR) analyses to identify the factors affecting each indicator.
The rates of total LTBI diagnosis, need for treatment, treatment initiation, and treatment completion were 15.2%, 10.2%, 69.4%, and 76.6%, respectively. After adjusting for other factors on MLR, the probability of diagnosis and need for treatment of latent TB in contacts was higher in most types of facilities than in schools. Conversely, treatment completion rates in these facilities were lower. Notably, the correctional institutions showed the highest odds ratio (OR) relative to school for LTBI diagnosis (OR, 6.37) and need for treatment (OR, 4.49) and the lowest OR for treatment completion (OR, 0.10).
This study provided evidence for the implementation of latent TB control policies in congregated settings.
本研究旨在比较潜伏性结核感染(LTBI)接触者管理的各项指标(诊断率、治疗需求率、治疗启动率和治疗完成率),并确定活动性结核病(TB)索引病例特征对学校、工作场所和医疗机构等聚集场所中暴露人群的影响。
提取并分析2013年至2016年结核病流行病学调查数据库中8648个群组的数据,以评估各项指标,并进行多水平逻辑回归(MLR)分析,以确定影响各指标的因素。
LTBI总诊断率、治疗需求率、治疗启动率和治疗完成率分别为15.2%、10.2%、69.4%和76.6%。在MLR中对其他因素进行调整后,大多数类型场所中接触者潜伏性结核的诊断和治疗需求概率高于学校。相反,这些场所的治疗完成率较低。值得注意的是,相对于学校,惩教机构的LTBI诊断优势比(OR)最高(OR,6.37),治疗需求优势比(OR,4.49),而治疗完成优势比最低(OR,0.10)。
本研究为在聚集场所实施潜伏性结核控制政策提供了依据。