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特立尼达和多巴哥国家结核病项目中的结核菌素皮肤试验筛查

Tuberculosis Skin Test Screening in the National Tuberculosis Program of Trinidad and Tobago.

作者信息

Chattu Vijay Kumar, Sakhamuri Sateesh, Motilal Shastri, Pounder Liam J, Persad Vasishma Kanita, Pierre Neelmani, Persad Shivannie, Pooran Nikesha, Pottinger Akua Mosi

机构信息

Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.

Occupational Medicine Clinic, St. Michael's Hospital, Toronto, ON M5C 2C5, Canada.

出版信息

Healthcare (Basel). 2020 Jul 27;8(3):236. doi: 10.3390/healthcare8030236.

Abstract

Globally, a quarter of the population is infected with tuberculosis (TB), caused by . About 5-10% of latent TB infections (LTBI) progress to active disease during the lifetime. Prevention of TB and treating LTBI is a critical component of the World Health Organization's (WHO) End TB Strategy. This study aims to examine the screening practices for prevention and treatment employed by the National Tuberculosis Program of Trinidad and Tobago in comparison to the WHO's standard guidelines. A cross-sectional retrospective study was conducted from the TB registers (2018-2019) for persons aged 18 years and above with recorded tuberculin skin test reactions (TST). Bivariate comparisons for categorical variables were made using Chi-square or Fisher's exact test. Binary logistic regression was used for exploring predictors of TST positivity with adjustment for demographic confounders in multivariable models. Of the total 1972 eligible entries studied, 384 (19.4%) individuals were tested positive with TST. TB contact screening (aOR 2.49; 95% CI 1.65, 3.75) and Bacillus Calmette-Guerin (BCG) vaccination status (aOR 1.66; 95% CI, 1.24 to 2.22) were associated with a positive TST reaction, whereas, preplacement screening failed to show such association when compared to those screened as suspect cases. The findings suggest that TB contact screening and positive BCG vaccination status are associated with TST positivity independent of age and gender.

摘要

在全球范围内,四分之一的人口感染了由……引起的结核病(TB)。大约5%-10%的潜伏性结核感染(LTBI)在一生中会发展为活动性疾病。预防结核病和治疗LTBI是世界卫生组织(WHO)终止结核病战略的关键组成部分。本研究旨在比较特立尼达和多巴哥国家结核病项目与WHO标准指南所采用的结核病预防和治疗筛查方法。对2018-2019年结核病登记册中记录了结核菌素皮肤试验反应(TST)的18岁及以上人群进行了横断面回顾性研究。分类变量的双变量比较采用卡方检验或Fisher精确检验。二元逻辑回归用于探索TST阳性的预测因素,并在多变量模型中对人口统计学混杂因素进行调整。在总共1972个符合条件的研究记录中,384人(19.4%)TST检测呈阳性。结核病接触者筛查(调整后比值比[aOR]=2.49;95%置信区间[CI]为1.65至3.75)和卡介苗(BCG)接种状况(aOR=1.66;95%CI为1.24至2.22)与TST阳性反应相关,而与作为疑似病例进行筛查的人群相比,上岗前筛查未显示出这种相关性。研究结果表明,结核病接触者筛查和BCG接种阳性与TST阳性相关,且不受年龄和性别的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ceb5/7551204/98e79afa6e20/healthcare-08-00236-g001.jpg

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