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在本地治里的游牧民和半游牧民中开展结核病主动病例发现工作。

Active case finding of tuberculosis among nomads and semi-nomads in Puducherry.

作者信息

Ramalingam Sivapragasam, Senthil Rajini, Dhasaram Premnath, Bajwin Faustina

机构信息

Department of Community Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, BIHER, Osudu, Agaram, Koodapakkam Post, Villianur Commune, Puducherry, India.

出版信息

J Family Med Prim Care. 2024 Jan;13(1):243-248. doi: 10.4103/jfmpc.jfmpc_1032_23. Epub 2024 Feb 8.

Abstract

CONTEXT

Tuberculosis (TB), is a global epidemic and communicable disease that accounts for increased global mortality and morbidity. India is also marching towards the elimination of tuberculosis by 2025 with this background we conducted this study.

AIMS

To identify the undiagnosed TB cases in nomadic and semi-nomadic populations of Puducherry.

SETTINGS AND DESIGN

A community-based cross-sectional study was done among nomads and semi-nomads in Puducherry for four months between May 2022 to September 2022 after getting the Institute's ethical committee approval.

METHODS AND MATERIAL

After obtaining written consent/assent, a pretested semi structured questionnaire was used to record the data. The questionnaire consists of three parts that include, sociodemographic details and history specific to tuberculosis based on operational definitions such as presumptive TB and physical examination. Those participants fulfilling the criteria for presumptive TB was provided a Falcon tube for spot sample. The participants were explained the procedure to collect the sputum and its quality was verified by the principal investigator before sending it to the laboratory.

STATISTICAL ANALYSIS USED

Data was analysed with Statistical Package for Social Science (SPSS Inc, Chicago, Illinois, USA) software version 16.0 and Microsoft Excel 2016. Frequencies and percentages were estimated for categorical data.

RESULTS

Our study showed 6.25% was the proportion of presumptive TB cases in our study population. In the presumptive TB cases 60% belonged to age >45yrs 80% belonged to the male gender and all of them belonged to lower socioeconomic status. The macro-environment findings of those presumptive TB cases were 80% belonged Kutcha houses, with poor ventilation and overcrowding present. Their co-morbidity status indicates 60% were diabetics and 20% were hypertensive. Their predominant findings were 80% reported Cough and 20% fever, significant weight loss. No contact history of TB was found. When these presumptive TB cases underwent microbiological examination, none were sputum positive.

CONCLUSIONS

This study showed ACF helped to identify presumptive TB in an effective way and needs large-scale screening to identify sputum-positive cases.

摘要

背景

结核病是一种全球性的流行病和传染病,导致全球死亡率和发病率上升。在这一背景下,印度也在朝着2025年消除结核病的目标迈进,我们开展了这项研究。

目的

确定本地治里邦游牧和半游牧人群中未被诊断出的结核病病例。

设置与设计

在获得研究所伦理委员会批准后,于2022年5月至2022年9月期间,在本地治里邦的游牧民和半游牧民中开展了一项基于社区的横断面研究,为期四个月。

方法与材料

在获得书面同意/应允后,使用经过预测试的半结构化问卷记录数据。该问卷由三部分组成,包括社会人口学细节以及基于推定结核病和体格检查等操作定义的结核病特定病史。那些符合推定结核病标准的参与者被提供一个福尔康管用于即时采样。向参与者解释了采集痰液的程序,在将痰液送往实验室之前,由主要研究者对其质量进行核实。

所用统计分析方法

使用社会科学统计软件包(SPSS Inc,美国伊利诺伊州芝加哥)16.0版软件和Microsoft Excel 2016对数据进行分析。对分类数据估计频率和百分比。

结果

我们的研究显示,研究人群中推定结核病病例的比例为6.25%。在推定结核病病例中,60%年龄>45岁,80%为男性,且他们都属于社会经济地位较低的人群。这些推定结核病病例的宏观环境调查结果显示,80%居住在 Kutcha 房屋中,通风不良且过度拥挤。他们的合并症状况表明,60%患有糖尿病,20%患有高血压。他们的主要症状为80%报告有咳嗽,20%有发热、显著体重减轻。未发现结核病接触史。当这些推定结核病病例接受微生物学检查时,无一例痰液呈阳性。

结论

本研究表明主动社区筛查有助于有效识别推定结核病病例,需要进行大规模筛查以识别痰液阳性病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddd7/10931871/a031ec5e31cd/JFMPC-13-243-g001.jpg

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