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将结核病筛查纳入挨家挨户的脊髓灰质炎疫苗接种活动。

Integrating TB screening into house-to-house polio vaccination campaigns.

作者信息

Ugwu C, Chukwulobelu U, Okeke E, Igboekwu C, Onyima A, Ibeziako V, Ebede C, Orjiagu U, Unamba V

机构信息

Zankli Research Centre, Bingham University, New Karu, Nigeria.

Liverpool School of Tropical Medicine, Liverpool, UK.

出版信息

Public Health Action. 2023 Mar 21;13(1):7-11. doi: 10.5588/pha.22.0055.

Abstract

SETTING

In July 2019, the Anambra State (south-east Nigeria) TB Control Programme implemented the integration of TB case-finding with the polio vaccination campaign with the support of the WHO.

OBJECTIVE

To improve TB case-finding from communities leveraging already existing polio structures.

DESIGN

Vaccination teams were trained to ask for symptoms of TB in each household and to document details of people presumed to have TB. Community TB workers subsequently tracked those identified for subsequent sample collection. We report the numbers detected, and the proportion of wards that reported people with TB. Regression analyses were used to estimate the relationship between ward characteristics and reporting. Odds ratios (ORs) with associated 95% confidence intervals (CIs) are also reported.

RESULTS

Of 281 people with presumptive TB, 32 were diagnosed with TB; 21% (70/330) of wards identified at least one presumptive, while 5% (18/330) of the people were identified with TB. Peri-urban slums were most likely to identify presumptives (adjusted OR [aOR] 11.52, 95% CI 1.62-81.79), while Riverine areas were most likely to identify a person with TB (aOR 3.59, 95% CI 1.16-11.01).

CONCLUSION

Integrating community TB case-finding into house-to-house vaccination campaigns can boost case detection. This approach proved effective in areas perennially underserved by routine healthcare services.

摘要

背景

2019年7月,在世界卫生组织的支持下,阿南布拉州(尼日利亚东南部)结核病控制项目将结核病病例发现工作与脊髓灰质炎疫苗接种活动相结合。

目的

利用现有的脊髓灰质炎防治结构,改善社区结核病病例发现情况。

设计

对接种团队进行培训,要求他们询问每户家庭中的结核病症状,并记录疑似结核病患者的详细信息。社区结核病防治人员随后对这些被确认的人员进行追踪,以便后续采集样本。我们报告了检测出的病例数,以及报告有结核病患者的病房比例。采用回归分析来估计病房特征与报告情况之间的关系。还报告了比值比(OR)及相关的95%置信区间(CI)。

结果

在281名疑似结核病患者中,有32人被确诊为结核病;21%(70/330)的病房发现了至少一名疑似患者,而5%(18/330)的人员被确诊为结核病。城郊贫民窟最有可能发现疑似患者(调整后的OR[aOR]为11.52,95%CI为1.62 - 81.79),而河流区域最有可能发现结核病患者(aOR为3.59,95%CI为1.16 - 11.01)。

结论

将社区结核病病例发现工作纳入挨家挨户的疫苗接种活动中,可以提高病例检出率。这种方法在长期缺乏常规医疗服务的地区被证明是有效的。

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