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巴西涂片阳性成人接触者中潜伏性结核病感染的患病率较低。

Low Prevalence of Latent Tuberculosis Infection among Contacts of Smear-Positive Adults in Brazil.

机构信息

Federal University of São João del-Rei, Minas Gerais, Brazil.

Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Am J Trop Med Hyg. 2019 Nov;101(5):1077-1082. doi: 10.4269/ajtmh.19-0100.

Abstract

This follow-up cross-sectional study aimed to analyze the prevalence rate and risk factors related to latent tuberculosis infection (LTBI) and active tuberculosis (TB) in children aged < 15 years in contact with adults with smear-positive pulmonary TB (PTB) in a Brazilian municipality. Data were collected from interviews, clinical evaluations, chest X-rays, tuberculin skin tests, and interferon gamma release assays. The median time elapsed between diagnosis of the index case (IC) and inclusion in the study was 2.5 years (interquartile range [IQR] = 1.5-4.4) and 7.4 years (IQR = 3.8-9.7) when we reassessed the development (or not) of active TB. The median age at the time of exposure to the IC was 6.6 years (IQR = 3.3-9.4) and 14.1 years (IQR = 8.9-17.7) at the last follow-up. Of the 99 children and adolescents in contact with smear-positive PTB, 21.2% (95% CI = 14.0-29.9) were diagnosed with LTBI, and none developed active TB. There was no statistically significant difference between the LTBI and non-LTBI groups regarding demographic, socioeconomic, and epidemiological characteristics. Unlike national and international scenarios, we found a lower frequency of LTBI and no active TB among our studied patients. For better understanding of these findings, further studies might add, among other factors, host and genetic features.

摘要

本随访性横断面研究旨在分析巴西某城市与涂阳肺结核(PTB)成人接触的<15 岁儿童中潜伏性结核感染(LTBI)和活动性肺结核(TB)的流行率及其相关危险因素。数据收集来自访谈、临床评估、胸部 X 光片、结核菌素皮肤试验和干扰素-γ释放试验。从确诊索引病例(IC)到纳入研究的中位时间为 2.5 年(四分位距 [IQR] = 1.5-4.4),重新评估活动性 TB 发展(或未发展)的中位时间为 7.4 年(IQR = 3.8-9.7)。接触 IC 时的中位年龄为 6.6 岁(IQR = 3.3-9.4),最后一次随访时为 14.1 岁(IQR = 8.9-17.7)。在与涂阳 PTB 接触的 99 名儿童和青少年中,21.2%(95%CI = 14.0-29.9)被诊断为 LTBI,且均未发生活动性 TB。LTBI 组和非 LTBI 组在人口统计学、社会经济和流行病学特征方面无统计学差异。与国内外情况不同,我们发现研究患者的 LTBI 频率较低,且无活动性 TB。为了更好地理解这些发现,进一步的研究可能需要纳入宿主和遗传特征等其他因素。

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