Mangione Carol M, Barry Michael J, Nicholson Wanda K, Cabana Michael, Chelmow David, Coker Tumaini Rucker, Davis Esa M, Donahue Katrina E, Jaén Carlos Roberto, Li Li, Ogedegbe Gbenga, Rao Goutham, Ruiz John M, Stevermer James, Underwood Sandra Millon, Wong John B
University of California, Los Angeles.
Harvard Medical School, Boston, Massachusetts.
JAMA. 2023 May 2;329(17):1487-1494. doi: 10.1001/jama.2023.4899.
In the US, tuberculosis remains an important preventable disease, including active tuberculosis, which may be infectious, and latent tuberculosis infection (LTBI), which is asymptomatic and not infectious but can later progress to active disease. The precise prevalence rate of LTBI in the US is difficult to determine; however, estimated prevalence is about 5.0%, or up to 13 million persons. Incidence of tuberculosis varies by geography and living accommodations, suggesting an association with social determinants of health.
To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on LTBI screening and treatment in asymptomatic adults seen in primary care, as well as the accuracy of LTBI screening tests.
Asymptomatic adults 18 years or older at increased risk for tuberculosis.
The USPSTF concludes with moderate certainty that there is a moderate net benefit in preventing active tuberculosis disease by screening for LTBI in persons at increased risk for tuberculosis infection.
The USPSTF recommends screening for LTBI in populations at increased risk. (B recommendation).
在美国,结核病仍然是一种重要的可预防疾病,包括具有传染性的活动性结核病,以及无症状且无传染性但日后可能进展为活动性疾病的潜伏性结核感染(LTBI)。美国LTBI的确切患病率难以确定;然而,估计患病率约为5.0%,即多达1300万人。结核病发病率因地理位置和居住条件而异,这表明与健康的社会决定因素有关。
为更新其2016年的建议,美国预防服务工作组(USPSTF)委托对初级保健中无症状成年人的LTBI筛查和治疗以及LTBI筛查试验的准确性进行系统评价。
年龄在18岁及以上、结核病风险增加的无症状成年人。
USPSTF中度确定地得出结论,对结核病感染风险增加的人群进行LTBI筛查,在预防活动性结核病方面有中度净效益。
USPSTF建议对风险增加的人群进行LTBI筛查。(B级推荐)