Sullam P M, Slutkin G, Hopewell P C
Am J Public Health. 1986 Sep;76(9):1109-11. doi: 10.2105/ajph.76.9.1109.
To determine the efficacy of evaluating persons (associates) in close contact to children with significant tuberculin reactions, we prospectively evaluated 831 associates of 297 children younger than eight years who had significant (greater than or equal to 10 mm) tuberculin reactions. Eighty-seven per cent of the index reactors were foreign-born, as were 84 per cent of the associates. All associates were evaluated by tuberculin skin testing; chest roentgenograms and sputum cultures were obtained if indicated. Four hundred sixty-one (55 per cent) of the associates had significant tuberculin reactions, and 15 had current tuberculosis. However, only three of these cases were newly discovered (total case rate: 1.81/100, new case rate: 0.36/100). Two of the three new cases were detected in the associates of children younger than three years of age. In addition, 338 candidates for isoniazid (INH) preventive therapy were found. We conclude that although the yield of new cases was low, the evaluation of associates did provide a convenient, high yield method of identifying candidates for INH preventive therapy. Moreover, it served as a useful mechanism for monitoring the adequacy of other case-finding activities.
为了确定对结核菌素反应呈强阳性的儿童的密切接触者（同事）进行评估的效果，我们前瞻性地评估了297名8岁以下结核菌素反应呈强阳性（大于或等于10毫米）儿童的831名密切接触者。87%的索引反应者出生于国外，密切接触者中这一比例为84%。所有密切接触者均接受结核菌素皮肤试验评估；如有指征，则进行胸部X光检查和痰培养。461名（55%）密切接触者结核菌素反应呈强阳性，15人患有现症结核病。然而，这些病例中只有3例是新发现的（总发病率：1.81/100，新发病率：0.36/100）。3例新病例中有2例是在3岁以下儿童的密切接触者中发现的。此外，还发现了338名异烟肼（INH）预防性治疗的候选者。我们得出结论，虽然新病例的检出率较低，但对密切接触者的评估确实提供了一种方便、高检出率的方法来识别INH预防性治疗的候选者。此外，它还是监测其他病例发现活动充分性的有用机制。
