Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität Munich, Munich, Germany.
Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
BMC Infect Dis. 2020 Apr 6;20(1):267. doi: 10.1186/s12879-020-04982-z.
International contact-tracing (CT) following exposure during long-distance air travel is resource-intensive, whereas evidence for risk of tuberculosis (TB) transmission during international travel is weak. In this study, we systematically analyzed the information from international requests for CT received at the national level in Germany in order to evaluate the continued utility of the current approach and to identify areas for improvement.
An anonymized archive of international CT notifications received by the Robert Koch Institute between 2010 and 2018 was searched for key parameters for data collection. A total of 31 parameters, such as characteristics of TB patients and their identified contacts, were extracted from each CT notification and collated into a dataset. Descriptive data analysis and trend analyses were performed to identify key characteristics of CT notifications, patients, and contacts over the years.
192 CT notifications, each corresponding to a single TB index case, were included in the study, increasing from 12 in 2010 to 41 in 2018. The majority of notifications (N = 130, 67.7%) concerned international air travel, followed by private contact (N = 39, 20.3%) and work exposure (N = 16, 8.3%). 159 (82.8%) patients had sputum smear results available, of which 147 (92.5%) were positive. Of 119 (62.0%) patients with drug susceptibility testing results, most (N = 92, 77.3%) had pan-sensitive TB, followed by 15 (12.6%) with multi-drug resistant TB. 115 (59.9%) patients had information on infectiousness, of whom 99 (86.1%) were considered infectious during the exposure period. 7 (5.3%) patients travelled on long-distance flights despite a prior diagnosis of active TB. Of the 771 contact persons, 34 (4.4%) could not be reached for CT measures due to lack of contact information.
The high variability in completeness of information contained within the international CT requests emphasizes the need for international standards for reporting of CT information. With the large proportion of TB patients reported to have travelled while being infectious in our study, we feel that raising awareness among patients and health professionals to detect TB early and prevent international long-distance travel during the infectious disease phase should be a cornerstone strategy to safeguard against possible transmission during international travel.
国际接触者追踪（CT）在长途航空旅行中接触后需要大量资源，而国际旅行中结核病（TB）传播的风险证据不足。在这项研究中，我们系统地分析了德国国家层面收到的国际 CT 要求的信息，以评估当前方法的持续效用，并确定改进领域。
检索 2010 年至 2018 年期间罗伯特·科赫研究所收到的国际 CT 通知匿名档案，以收集数据收集的关键参数。从每个 CT 通知中提取了 31 个参数，例如 TB 患者及其确定的接触者的特征，并将其整理到一个数据集。对多年来 CT 通知、患者和接触者的关键特征进行描述性数据分析和趋势分析。
本研究共纳入 192 项 CT 通知，每项通知对应一个 TB 索引病例，从 2010 年的 12 项增加到 2018 年的 41 项。大多数通知（N=130，67.7%）涉及国际航空旅行，其次是私人接触（N=39，20.3%）和工作接触（N=16，8.3%）。159 名（82.8%）患者有痰涂片结果，其中 147 名（92.5%）为阳性。119 名（62.0%）患者有药敏试验结果，其中大多数（N=92，77.3%）为泛敏感 TB，其次是 15 名（12.6%）耐多药 TB。115 名（59.9%）患者有传染性信息，其中 99 名（86.1%）在暴露期间被认为具有传染性。尽管有 7 名（5.3%）患者患有活动性结核病，但仍乘坐长途航班旅行。在 771 名接触者中，由于缺乏联系方式，有 34 名（4.4%）无法进行 CT 措施。
国际 CT 请求中包含的信息完整性差异很大，这强调了需要制定国际 CT 信息报告标准。在我们的研究中，报告有很大比例的 TB 患者在具有传染性时旅行，我们认为提高患者和卫生专业人员的认识，以便早期发现结核病并防止在传染病阶段进行国际长途旅行，应成为防止国际旅行中可能传播的基石策略。
