Ur-Rehman Saleem, Kausar Rehana, Kadri Syed M, Jan Nasreen, Bhat Bilal, Najar S, Chattu Vijay K
Director of Health Services, Kashmir, Jammu and Kashmir, India.
Directorate of Health Services, Kashmir, Jammu and Kashmir, India.
J Family Med Prim Care. 2020 Jan 28;9(1):56-60. doi: 10.4103/jfmpc.jfmpc_179_19. eCollection 2020 Jan.
India has the highest burden of both Tuberculosis and MDR-Tuberculosis based on estimates reported in the Global Tuberculosis Report 2016. The estimates have been revised upwards based on the newer evidence, and the current study was done to estimate the prevalence of bacteriologically positive pulmonary Tuberculosis among the adult population and to provide baseline information for future measurements of Tuberculosis burden and trends.
A cluster-based sampling design was adopted in 10 districts of Kashmir valley in India. Assuming a prevalence of 217 per lakh population, a design effect of 2.5, a relative precision of 0.25% and the expected participation rate of 80%, a sample size of 49,716 was achieved. A total of 67 clusters were identified where each cluster had 750 subjects aged ≥15 years, and eligible individuals were questioned for pulmonary symptoms suggestive of Tuberculosis.
Of the total 42,805 that were interviewed, 3.85% had pulmonary Tuberculosis symptoms. A total of 1539 sputum samples were collected from symptomatic and 1351 chest X- rays were done. Cartridge based nucleic acid amplification test (CBNAAT) tests were done on individuals with suspicious X-ray findings. The prevalence of bacteriologically positive pulmonary Tuberculosis was found to be 147 per 100,000 population. Females are affected more than males, and the age of female Tuberculosis patients is less than that of males.
The study is the first survey of its kind providing a baseline for further research in the state. CBNAAT is going to be game-changer which surmounts the drawbacks of sputum smear microscopy.
根据《2016年全球结核病报告》中的估计，印度的结核病和耐多药结核病负担最为沉重。基于新的证据，这些估计数已向上修正，开展本项研究是为了估计成年人群中痰菌阳性肺结核的患病率，并为今后结核病负担和趋势的测量提供基线信息。
在印度克什米尔山谷的10个地区采用基于整群抽样的设计。假设每10万人中有217人患病，设计效应为2.5，相对精度为0.25%，预期参与率为80%，最终获得了49716的样本量。总共确定了67个群组，每个群组有750名年龄≥15岁的受试者，符合条件的个体被询问是否有提示结核病的肺部症状。
在接受访谈的42805人中，3.85%有肺结核症状。共从有症状者中采集了1539份痰标本，并进行了1351次胸部X光检查。对X光检查结果可疑的个体进行了基于 cartridge 的核酸扩增试验（CBNAAT）检测。痰菌阳性肺结核的患病率为每10万人中有147人。女性受影响的人数多于男性，女性结核病患者的年龄小于男性。
本研究是该州同类研究中的首次调查，为进一步研究提供了基线。CBNAAT 将成为改变局面的因素，它克服了痰涂片显微镜检查的缺点。
