Shinjuku City Health Office, Tokyo, Japan.
Research Institute of Tuberculosis, Tokyo, Japan.
Int J Mycobacteriol. 2020 Jan-Mar;9(1):53-57. doi: 10.4103/ijmy.ijmy_177_19.
The aim of this study is to analyze interferon-gamma release assay (IGRA) data of foreign-born individuals in Japan derived from tuberculosis (TB) contact investigations.
A contact with a TB patient was considered to have occurred when an individual had contact with a TB patient for more than 8 h indoors. This is a retrospective cohort study, and all the TB contacts tested with IGRA during the contact investigations conducted by the Shinjuku city Health Office from 2015 through 2017 were enrolled.
A total of 880 foreign-born contacts were investigated. The IGRA positivity of the contacts from China and Viet Nam were both 5.1% (95% confidence intervals [CIs]: 3.2%-7.8% and 2.4%-9.5%, respectively), whereas that from Nepal and Myanmar were 24.4% (95% CI: 16.0%-34.6%) and 23.3% (95% CI: 9.9%-42.3%), respectively. Multiple logistic regression analysis showed that the risk factors were smear status of the index patient (1+: adjusted odds ratio [aOR]: 6.2, 95% CI: 1.2-30.5, smear status 3+: aOR: 14.3, 95% CI: 1.7-118.2), age of the contact (aOR: 1.1, 95% CI: 1.0-1.1 for 1 year increment), and being born in Nepal (aOR: 5.6, 95% CI: 2.8-11.2) and Myanmar (aOR: 4.3, 95% CI: 1.4-13.0), compared with China as reference.
In contact investigations involving foreign-born individuals, local health offices should carefully consider the composition of the TB contacts and expand the focus of the investigation, if deemed necessary.
本研究旨在分析源自日本的外国出生人群结核接触者中干扰素 -γ释放试验(IGRA)的数据。
当个体与结核患者在室内接触超过 8 小时时,即认为发生了接触。这是一项回顾性队列研究,纳入了 2015 年至 2017 年新宿市卫生局进行的接触者调查中使用 IGRA 检测的所有结核接触者。
共调查了 880 名外国出生的接触者。来自中国和越南的接触者的 IGRA 阳性率均为 5.1%(95%置信区间[CI]:3.2%-7.8%和 2.4%-9.5%),而来自尼泊尔和缅甸的接触者分别为 24.4%(95%CI:16.0%-34.6%)和 23.3%(95%CI:9.9%-42.3%)。多因素逻辑回归分析显示,危险因素包括索引患者的涂片状态(1+:调整优势比[aOR]:6.2,95%CI:1.2-30.5,涂片状态 3+:aOR:14.3,95%CI:1.7-118.2)、接触者年龄(aOR:1.1,95%CI:1.0-1.1,每增加 1 岁)、出生于尼泊尔(aOR:5.6,95%CI:2.8-11.2)和缅甸(aOR:4.3,95%CI:1.4-13.0),与中国作为参照相比。
在涉及外国出生人群的接触者调查中,当地卫生部门应根据需要仔细考虑结核接触者的构成,并扩大调查重点。