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GeneXpert® MTB/RIF 快速分子检测对结核病检测的影响:时间趋势和脆弱地区。

Impact of the GeneXpert® MTB/RIF rapid molecular test on tuberculosis detection: temporal trends and vulnerable territories.

机构信息

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Scholarship holder at the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Brazil.

出版信息

Rev Lat Am Enfermagem. 2021 Jul 19;29:e3441. doi: 10.1590/1518.8345.4412.3441. eCollection 2021.

Abstract

OBJECTIVE

to assess the impact of the GeneXpert® MTB/RIF rapid molecular test on tuberculosis detection, to analyze the temporal trend of the event and to identify vulnerable territories in a Brazilian municipality.

METHOD

an ecological study carried out in Ribeirão Preto, São Paulo, Brazil, a municipality considered a priority in tuberculosis control due to the high number of cases. To classify the temporal trend, the Prais-Winsten method and the Interrupted Time Series were used to identify changes in the disease incidence. Kernel intensity analysis was applied to identify vulnerable areas.

RESULTS

the temporal trend of tuberculosis decreased by 18.1%/year and by 6.9%/year for children under 15 years old. The North District decreased by 6.67%/year and the East District increased by 17.5%/year in the incidence of tuberculosis. Resistant tuberculosis, after the implementation of the Rapid Molecular Test, increased by 0.6% per year. The South and West Districts showed a higher density of cases, with a range from 45 to 79 tuberculosis cases per square kilometer (km2).

CONCLUSION

although resistant tuberculosis is not a problem in the scenario, the study showed an increase in its incidence, which puts it on alert. The use of spatial analysis enabled the identification of priority areas, putting them in evidence for health surveillance actions.

摘要

目的

评估 GeneXpert® MTB/RIF 快速分子检测对结核病检测的影响,分析该事件的时间趋势,并确定巴西一城市的脆弱地区。

方法

这是在巴西圣保罗州里贝朗普雷图市进行的一项生态学研究,该市由于病例数量多,被认为是结核病控制的重点地区。为了对时间趋势进行分类,采用了普赖斯-温斯坦方法和中断时间序列来识别疾病发病率的变化。还应用核密度强度分析来识别脆弱地区。

结果

结核病的时间趋势呈每年下降 18.1%,15 岁以下儿童每年下降 6.9%。北部地区结核病发病率每年下降 6.67%,东部地区每年上升 17.5%。快速分子检测实施后,耐多药结核病每年增加 0.6%。南部和西部地区的病例密度较高,每平方公里(km2)有 45 至 79 例结核病。

结论

尽管在该情景中耐多药结核病不是一个问题,但研究表明其发病率有所增加,这引起了警惕。空间分析的使用能够识别重点地区,并为卫生监测行动提供证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bea8/8294793/fa19cb71bd45/0104-1169-rlae-29-e3441-gf01.jpg

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