Victorian Tuberculosis Program, Melbourne Health, Parkville, Victoria, Australia.
Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute, Melbourne, Victoria, Australia.
Public Health Genomics. 2024;27(1):68-73. doi: 10.1159/000537727. Epub 2024 Mar 20.
One of the primary public health functions of a tuberculosis (TB) program is to arrest the spread of infection. Traditionally, TB programs have relied on epidemiological information, gathered through contact tracing, to infer that transmission has occurred between people. The ability of drawing such inferences is extensively context dependent. Where epidemiological information has been strong, such as 2 cases of TB occurring sequentially within a single household, confidence in such inferences is high; conversely, public health authorities have been less certain about the significance of TB cases merely occurring in the same wider social group or geographic area. Many current laboratory tests for TB used globally may be sufficient to confirm a diagnosis and guide appropriate therapy but still be insufficiently precise for distinguishing two strains reliably. In short, drawing inferences regarding a chain of transmissions has always been as much art as science.
结核病（TB）防控规划的主要公共卫生职能之一是阻止感染的传播。传统上，结核病防控规划依赖于通过接触者追踪收集的流行病学信息来推断人际间发生了传播。这种推断能力广泛地取决于具体情况。在流行病学信息较强的情况下，例如在单个家庭中连续发生 2 例结核病，可以高度确信这种推断；相反，对于仅在同一更大的社会群体或地理区域中发生的结核病病例，公共卫生当局就不太确定其意义。目前在全球范围内使用的许多结核病实验室检测可能足以确诊并指导适当的治疗，但对于可靠地区分两种菌株仍然不够精确。简而言之，推断传播链一直既是一门科学，也是一门艺术。
