1. The First Affiliated Hospital, Zhejiang University School of Medicine, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China.
2. Jinan Microecological Biomedicine Shandong Laboratory, Jinan 250117, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2022 Dec 25;51(6):669-678. doi: 10.3724/zdxbyxb-2022-0426.
Despite the achievements obtained worldwide in the control of tuberculosis in recent years, many countries and regions including China still face challenges such as low diagnosis rate, high missed diagnosis rate, and delayed diagnosis of the disease. The discovery strategy of tuberculosis in China has changed from "active discovery by X-ray examination" to "passive discovery by self-referral due to symptoms", and currently the approach is integrated involving self-referral due to symptoms, active screening, and physical examination. Active screening could help to identify early asymptomatic and untreated cases. With the development of molecular biology and artificial intelligence-assisted diagnosis technology, there are more options for active screening among the large-scale populations. Although the implementation cost of a population-based active screening strategy is high, it has great value in social benefits, and active screening in special populations can obtain better benefits. Active screening of tuberculosis is an important component of the disease control. It is suggested that active screening strategies should be optimized according to the specific conditions of the regions to ultimately ensure the benefit of the tuberculosis control.
尽管近年来全球在结核病控制方面取得了成就,但包括中国在内的许多国家和地区仍然面临着诊断率低、漏诊率高和诊断延误等挑战。中国结核病的发现策略已从“X 射线检查主动发现”转变为“因症状而被动发现”,目前的方法是整合因症状而主动发现、主动筛查和体检。主动筛查有助于发现早期无症状和未经治疗的病例。随着分子生物学和人工智能辅助诊断技术的发展,在大规模人群中,主动筛查有更多的选择。虽然基于人群的主动筛查策略的实施成本很高,但它在社会效益方面具有很大的价值,对特殊人群进行主动筛查可以获得更好的效益。主动筛查结核病是疾病控制的重要组成部分。建议根据地区具体情况优化主动筛查策略,最终确保结核病控制的效益。