Khan Palwasha Y, Paracha M Shariq, Grundy Chris, Saeed Saadia, Dojki Maqboola, Madhani Falak, Page-Shipp Liesl, Khursheed Nazia, Rabbani Waleed, Riaz Najam, Khowaja Saira, Hussain Owais, Habib Ali, Khan Uzma, Kranzer Katharina, Ferrand Rashida A, Lewis James J, Khan Aamir J, Fielding Katherine L
Interactive Research and Development, Karachi, Pakistan.
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Wellcome Open Res. 2020 Jul 6;5:159. doi: 10.12688/wellcomeopenres.15963.1. eCollection 2020.
Assessment of the effectiveness of tuberculosis control strategies requires the periodic measurement of transmission in populations, which is notoriously difficult. One well-established method is to measure the prevalence of infectious pulmonary tuberculosis in the population which is then repeated at a second time point after a period of 'intervention', such as scale up of the Search-Treat-Prevent strategy of the Zero TB Cities initiative, allowing for a 'before and after' comparison. The concurrent adult pulmonary tuberculosis prevalence survey (using digital radiography and Xpert MTB/RIF Ultra) and child infection survey (using QuantiFERON-TB® Gold Plus) will primarily provide a baseline measure of the burden of adult infectious tuberculosis in Karachi and assess whether a large-scale interferon gamma release assay survey in children aged 2 to 4 years is feasible. The target population for the prevalence survey is comprised of a stratified random sample of all adults aged 15 years and above and all children aged 2 to 4 years resident in four districts in Karachi. The survey procedures and analyses to estimate pulmonary tuberculosis prevalence are based on the World Health Organization methodology for tuberculosis prevalence surveys. The study protocol has been approved by the Interactive Research Development / The Indus Hospital Research Centre Research Ethics Committee in Karachi, Pakistan and the London School of Hygiene & Tropical Medicine Research Ethics Committee. Due to non-representative sampling in this setting, where a large proportion of the population are illiterate and are reluctant to provide fingerprints due to concerns about personal security, verbal informed consent will be obtained from each eligible participant or guardian. Results will be submitted to international peer-reviewed journals, presented at international conferences and shared with participating communities and with the Provincial and National TB programme.
评估结核病控制策略的有效性需要定期测量人群中的传播情况，而这一工作众所周知难度很大。一种成熟的方法是测量人群中传染性肺结核的患病率，然后在一段“干预”期（如扩大“零结核病城市倡议”的“搜索-治疗-预防”策略规模）后，在第二个时间点重复测量，以便进行“前后”对比。成人肺结核患病率同期调查（使用数字X线摄影和Xpert MTB/RIF Ultra）以及儿童感染调查（使用QuantiFERON-TB® Gold Plus）将主要提供卡拉奇成人传染性肺结核负担的基线测量值，并评估对2至4岁儿童进行大规模干扰素γ释放试验调查是否可行。患病率调查的目标人群包括卡拉奇四个区所有15岁及以上成年人和所有2至4岁儿童的分层随机样本。估计肺结核患病率的调查程序和分析基于世界卫生组织的肺结核患病率调查方法。该研究方案已获得巴基斯坦卡拉奇互动研究发展/印度河医院研究中心研究伦理委员会以及伦敦卫生与热带医学院研究伦理委员会的批准。由于在这种情况下抽样缺乏代表性，当地很大一部分人口是文盲，且因担心个人安全而不愿提供指纹，因此将从每位符合条件的参与者或监护人处获得口头知情同意。研究结果将提交给国际同行评审期刊，在国际会议上发表，并与参与社区以及省级和国家级结核病项目分享。
