Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Sci Rep. 2022 Aug 18;12(1):14094. doi: 10.1038/s41598-022-18456-6.
Mobile screening units can help close tuberculosis case detection gaps. Placing screening units where people at high risk for undiagnosed tuberculosis preferentially spend time could make screening more resource-effective. We conducted a case-control study in Lima, Peru to identify locations where people with tuberculosis were more likely to spend time than community controls. We surveyed participants about activity locations over the past 6 months. We used density-based clustering to assess how patient and control activity locations differed, and logistic regression to compare location-based exposures. We included 109 tuberculosis patients and 79 controls. In density-based clustering analysis, the two groups had similar patterns of living locations, but their work locations clustered in distinct areas. Both groups were similarly likely to use public transit, but patients predominantly used buses and were less likely to use rapid transit (adjusted odds ratio [aOR] 0.31, 95% confidence interval [CI] 0.10-0.96) or taxis (aOR 0.42, 95% CI 0.21-0.85). Patients were more likely to have spent time in prison (aOR 11.55, 95% CI 1.48-90.13). Placing mobile screening units at bus terminals serving locations where tuberculosis patients have worked and within and around prisons could help reach people with undiagnosed tuberculosis.
移动筛查单元有助于缩小结核病病例检测差距。将筛查单元设置在高危人群优先花费时间的地方，可以使筛查更具资源效益。我们在秘鲁利马进行了一项病例对照研究，以确定结核病患者更有可能花费时间的地点，而不是社区对照。我们调查了参与者过去 6 个月的活动地点。我们使用基于密度的聚类来评估患者和对照活动地点的差异，并使用逻辑回归来比较基于位置的暴露情况。我们纳入了 109 例结核病患者和 79 例对照。在基于密度的聚类分析中，两组的居住地点模式相似，但他们的工作地点聚集在不同的区域。两组使用公共交通的可能性相似，但患者主要使用公共汽车，而不太可能使用快速公交（调整后的优势比[aOR]0.31，95%置信区间[CI]0.10-0.96）或出租车（aOR 0.42，95%CI 0.21-0.85）。患者更有可能在监狱中度过时间（aOR 11.55，95%CI 1.48-90.13）。在为结核病患者工作地点和监狱内外提供服务的公共汽车终点站设置移动筛查单元，可能有助于发现未确诊的结核病患者。
