Mudoola Denis, Thekkur Pruthu, Nsonga Joseph, Mande Ritah, Berger Selma Dar, Turyahabwe Stavia, Muchuro Simon, Namuwenge Proscovia, Sekadde Moorine, Lukoye Deus, Luzze Henry, Dongo John Paul, Date Anand, Dlodlo Riitta A, Ferroussier-Davis Odile, Charles Macarthur
MMWR Morb Mortal Wkly Rep. 2025 Mar 20;74(9):145-151. doi: 10.15585/mmwr.mm7409a1.
To help achieve the End TB Strategy target of a 90% reduction in tuberculosis (TB) incidence by 2030, member states of the United Nations High-Level Meetings on TB called for improving provision of TB preventive treatment (TPT) for household contacts of persons with TB, who are at increased risk for infection and disease. However, TPT use among household contacts worldwide remained at 21% in 2023. The International Union Against Tuberculosis and Lung Disease, the Uganda Ministry of Health, and CDC piloted a comprehensive approach for increasing case finding and TPT coverage among household contacts of persons with TB. During November 1, 2023-September 30, 2024, a total of 521 index patients with TB disease were registered at six health facilities in Uganda. Home visits to index patients identified 1,913 household contacts, 1,739 (91.0%) of whom underwent TB symptom screening at home; 321 (18.5%) reported TB symptoms. Of 309 (96.3%) persons with TB symptoms who were further evaluated, 284 (91.9%) provided a sputum specimen for laboratory testing, including 270 (84.1% of those with symptoms) who did so during the home visit; 214 (69.3%) underwent chest radiography. Overall, 80 TB cases were diagnosed; in 61 (76.3%) persons, the diagnosis was based on radiographic findings. Among 1,496 HHCs eligible for TPT, 1,239 (82.8%) initiated treatment and 1,178 (95.1%) completed it. Global scale-up of this approach might help reach global TB elimination goals.
为助力实现《终止结核病战略》中到2030年将结核病发病率降低90%的目标，联合国结核病问题高级别会议的成员国呼吁改善对结核病患者家庭接触者的结核病预防性治疗（TPT）服务，这些接触者感染和患病风险更高。然而，2023年全球家庭接触者中TPT的使用率仍为21%。国际防痨和肺部疾病联盟、乌干达卫生部以及美国疾病控制与预防中心试点了一种综合方法，以增加结核病患者家庭接触者中的病例发现率和TPT覆盖率。在2023年11月1日至2024年9月30日期间，乌干达的六家医疗机构共登记了521例结核病确诊患者。对确诊患者进行家访后确定了1913名家庭接触者，其中1739人（91.0%）在家中接受了结核病症状筛查；321人（18.5%）报告有结核病症状。在进一步接受评估的309名（96.3%）有结核病症状的人中, 284人（91.9%）提供了痰标本用于实验室检测，其中270人（占出现症状者的84.1%）是在家访期间提供的；214人（69.3%）接受了胸部X光检查。总体而言，共诊断出80例结核病病例；其中61人（76.3%）的诊断基于X光检查结果。在1496名符合TPT条件的家庭接触者中，1239人（82.8%）开始治疗，1178人（95.1%）完成了治疗。在全球范围内推广这种方法可能有助于实现全球消除结核病的目标。
