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亚临床结核病病 - 流行情况调查的综述和分析，为定义、负担、关联和筛查方法提供信息。

Subclinical Tuberculosis Disease-A Review and Analysis of Prevalence Surveys to Inform Definitions, Burden, Associations, and Screening Methodology.

机构信息

School of Public Health, Vita-Salute San Raffaele University, Milan, Italy.

TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London,United Kingdom.

出版信息

Clin Infect Dis. 2021 Aug 2;73(3):e830-e841. doi: 10.1093/cid/ciaa1402.

DOI:10.1093/cid/ciaa1402
PMID:32936877
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8326537/
Abstract

While it is known that a substantial proportion of individuals with tuberculosis disease (TB) present subclinically, usually defined as bacteriologically-confirmed but negative on symptom screening, considerable knowledge gaps remain. Our aim was to review data from TB prevalence population surveys and generate a consistent definition and framework for subclinical TB, enabling us to estimate the proportion of TB that is subclinical, explore associations with overall burden and program indicators, and evaluate the performance of screening strategies. We extracted data from all publicly available prevalence surveys conducted since 1990. Between 36.1% and 79.7% (median, 50.4%) of prevalent bacteriologically confirmed TB was subclinical. No association was found between prevalence of subclinical and all bacteriologically confirmed TB, patient diagnostic rate, or country-level HIV prevalence (P values, .32, .4, and .34, respectively). Chest Xray detected 89% (range, 73%-98%) of bacteriologically confirmed TB, highlighting the potential of optimizing current TB case-finding policies.

摘要

虽然已知大量结核病（TB）患者表现为亚临床状态，通常定义为细菌学确诊但症状筛查阴性，但仍存在大量知识空白。我们的目的是回顾结核病患病率人群调查的数据，并为亚临床结核病制定一致的定义和框架，使我们能够估计亚临床结核病的比例，探讨与总体负担和规划指标的关联，并评估筛查策略的性能。我们从 1990 年以来所有公开的患病率调查中提取了数据。在现患的所有经细菌学确诊的结核病中，有 36.1%至 79.7%（中位数为 50.4%）为亚临床。亚临床和所有经细菌学确诊的结核病、患者诊断率或国家一级艾滋病毒流行率之间未发现相关性（P 值分别为.32、.4 和.34）。胸部 X 射线检测出 89%（范围为 73%-98%）的经细菌学确诊的结核病，突出了优化当前结核病发现政策的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/49bf404ff9dc/ciaa1402f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/350c1ae12ed4/ciaa1402f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/2beb0a541d84/ciaa1402f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/3a555f9fb1f3/ciaa1402f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/5cfdc531dcf6/ciaa1402f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/49bf404ff9dc/ciaa1402f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/350c1ae12ed4/ciaa1402f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/2beb0a541d84/ciaa1402f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/3a555f9fb1f3/ciaa1402f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/5cfdc531dcf6/ciaa1402f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af7/8326537/49bf404ff9dc/ciaa1402f0005.jpg

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