Le Gales C, Lefaure C, Hirsch A, Bouvet-Koskas E
Rev Epidemiol Sante Publique. 1987;35(2):117-28.
A survey of 984 cases of pulmonary tuberculosis was carried out to assist French public health authorities in determining policies for pulmonary tuberculosis detection. The adjusted sample was representative of the totality of pulmonary tuberculosis cases reported. The survey made it possible to define the economic and socio-demographic characteristics (age, nationality, lack of social security coverage, living conditions) which, when combined, represent high-risk attributes with regard to pulmonary tuberculosis. Nonetheless, over half the subjects studied presented no risk factors. Systematic X-ray screening of an undifferentiated population permits detection of about 23% of reported cases; among them, 26 or 50% (depending on the definition of contagiousness chosen) were contagious. In 1982, 9 million systematic X-ray screenings were performed and about 13,100 cases of pulmonary tuberculosis reported. When extrapolated to these 1982 figures, our survey conclusions point to an effectiveness rate for systematic X-ray screening of 33.7 per 100,000 for the overall tuberculosis population, and between 8.9 and 17.4 per 100,000 for contagious cases. On the other hand, high-risk groups (female immigrants, the aged, etc.) do not seem to be particularly well covered by systematic X-ray screening. Thus, maintaining such a program no longer appears justified either in terms of the overall tuberculosis population or that of high-risk subgroups.
对984例肺结核病例进行了调查，以协助法国公共卫生当局确定肺结核检测政策。调整后的样本代表了所报告的全部肺结核病例。该调查使得能够确定经济和社会人口特征（年龄、国籍、缺乏社会保障覆盖、生活条件），这些特征综合起来代表了肺结核的高风险属性。尽管如此，超过一半的研究对象没有呈现出风险因素。对未分化人群进行系统性X线筛查可检测出约23%的报告病例；其中，26例或50%（取决于所选择的传染性定义）具有传染性。1982年，进行了900万次系统性X线筛查，报告了约13100例肺结核病例。根据1982年的这些数据进行推断，我们的调查结论表明，系统性X线筛查对总体肺结核人群的有效率为每10万人33.7例，对传染性病例的有效率为每10万人8.9至17.4例。另一方面，系统性X线筛查似乎并未很好地覆盖高危人群（女性移民、老年人等）。因此，无论是就总体肺结核人群还是高危亚组而言，维持这样一个项目似乎都不再合理。
