Jayasooriya S, Jobe A, Badjie S, Owolabi O, Rachow A, Sutherland J, Kampmann B
Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, London, UK.
School of Health Sciences and Related Research, University of Sheffield, Sheffield, UK.
Public Health Action. 2019 Dec 21;9(4):166-168. doi: 10.5588/pha.19.0046.
In some low and middle-income countries, 10-20% of patients presenting with a persistent cough have tuberculosis (TB). Once TB is excluded, health service provision for alternative diagnoses is limited. We prospectively studied patients with two Xpert-negative sputum results presenting to a TB clinic in The Gambia. Of 239 patients, 108 did not have TB; 65/102 (6 were lost to follow-up) had alternative diagnoses, 24.6% of which were non-respiratory; 37/102 had no diagnosis, 27.0% of whom were HIV-1-positive; 37.8% had a history of TB and 24.3% smoked. We highlight the need for general health service integration with TB platforms and exploration of non-TB patients with chronic respiratory symptoms.
在一些低收入和中等收入国家，出现持续性咳嗽症状的患者中有10%至20%患有结核病（TB）。一旦排除结核病，针对其他诊断的医疗服务就很有限。我们对在冈比亚一家结核病诊所就诊、痰涂片Xpert检测结果为阴性的患者进行了前瞻性研究。在239名患者中，108名没有患结核病；102名（其中6名失访）有其他诊断，其中24.6%为非呼吸道疾病；102名中有37名未明确诊断，其中27.0%为HIV-1阳性；37.8%有结核病病史，24.3%吸烟。我们强调需要将一般医疗服务与结核病诊疗平台整合，并对有慢性呼吸道症状的非结核病患者进行排查。
