Madan A, Malik A A, Brooks M B
Boston University School of Public Health, Boston, MA, USA.
University of Texas Southwest, Dallas, TX, USA.
Public Health Action. 2025 Mar 1;15(1):4-11. doi: 10.5588/pha.24.0052. eCollection 2025 Mar.
TB poses a significant global health challenge due to a substantial case-detection gap. Traditional contact tracing primarily targets contacts of bacteriologically confirmed pulmonary TB index patients, often excluding pediatric, clinically diagnosed, and extrapulmonary cases. This review assessed the potential of expanding contact tracing to these frequently overlooked subgroups.
We conducted a focused, targeted literature review by searching PubMed, Web of Science, Google Scholar and Lens.org using identified keywords. A title and abstract review was conducted using predefined inclusion/exclusion criteria.
We identified 13 relevant studies reporting contact tracing yields from these index patient groups. Contact tracing of pediatric, clinically diagnosed, and extrapulmonary TB index patients yielded up to 8.1%, 3.0%, and 2.1% for active disease and up to 17.9%, 12.6%, and 11.1% for TB infection, respectively.
Findings suggest that expanding contact tracing for these typically excluded index patients can improve case detection. By refining contact tracing protocols and adopting more inclusive strategies, TB programs can enhance case detection rates and improve overall disease control efforts, aligning with global goals for TB elimination.
由于病例发现存在巨大差距，结核病对全球健康构成重大挑战。传统的接触者追踪主要针对经细菌学确诊的肺结核索引患者的接触者，通常将儿童、临床诊断病例和肺外病例排除在外。本综述评估了将接触者追踪扩大到这些经常被忽视的亚组的潜力。
我们通过使用确定的关键词在PubMed、科学网、谷歌学术和Lens.org上进行搜索，开展了一项有针对性的文献综述。使用预先定义的纳入/排除标准对标题和摘要进行审查。
我们确定了13项相关研究，报告了这些索引患者组的接触者追踪结果。儿童、临床诊断和肺外结核索引患者的接触者追踪中，活动性疾病的检出率分别高达8.1%、3.0%和2.1%，结核感染的检出率分别高达17.9%、12.6%和11.1%。
研究结果表明，对这些通常被排除在外的索引患者扩大接触者追踪可以提高病例发现率。通过完善接触者追踪方案并采用更具包容性的策略，结核病防治项目可以提高病例发现率，改善整体疾病控制工作，符合全球消除结核病的目标。
