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[1992/1993年伯尔尼州、纳沙泰尔州和瓦莱州离校学生的结核菌素试验]

[Tuberculin tests in school leavers in canton Berne , Neuenburg and Wallis 1992/1993].

作者信息

Schalcher C, Brändli O, Beran J, Gaze H, Howald H, Tschopp J M

机构信息

Zürcher Höhenklinik Wald, Faltigberg-Wald.

出版信息

Schweiz Med Wochenschr. 1995 Apr 22;125(16):796-801.

PMID:7732353
Abstract

To determine the prevalence of tuberculosis infection in Switzerland, standardized tuberculin tests using 2 units of tuberculin Berna PPD RT 23, administered by specially trained personnel, were performed on school leavers in 3 Swiss cantons in 1992/1993. Of the 7036 school leavers, averaging 15 years of age, only 294 (4.18%) were not BCG-vaccinated. Non-vaccinated persons had tuberculin test indurations > 15 mm in 2.04% (6663 BCG vaccinated persons in 1.14%). Calculations of potentially influential factors using stepwise ordinal polychotomous regression showed that tuberculin test indurations are significantly larger after BCG vaccination, as well as with increasing age at immigration from high prevalence tuberculosis countries. Indurations were smaller with increasing time passed since BCG vaccination, as well as in females. Pets at home did not significantly influence the size of tuberculin reactions. Theoretically the positive predictive value of tuberculin tests in Switzerland is small because of the low tuberculosis prevalence. From our data the maximal prevalence of infection in 15-year-olds is estimated at 0.91% (2.48% in the non-vaccinated) in Swiss and 2.54% (9.77% in the non-vaccinated) in foreign born school children. These rates, higher than extrapolated from previous studies, are comparable to data from other industrialized countries. They do not warrant a change in BCG vaccination policy in Switzerland, which since 1987 requires BCG vaccination in children immigrating from countries with high tuberculosis prevalence only.

摘要

为确定瑞士结核病感染的流行情况,1992/1993年对瑞士3个州的离校学生进行了标准化结核菌素试验,使用2单位的伯尔尼结核菌素PPD RT 23,由经过专门培训的人员进行操作。在7036名平均年龄为15岁的离校学生中,只有294人(4.18%)未接种卡介苗。未接种者结核菌素试验硬结>15 mm的比例为2.04%(接种卡介苗的6663人中这一比例为1.14%)。使用逐步有序多分类回归对潜在影响因素进行计算表明,卡介苗接种后结核菌素试验硬结明显更大,以及来自结核病高流行国家的移民年龄越大,硬结也越大。随着卡介苗接种后时间的增加以及女性的硬结较小。家中饲养宠物对结核菌素反应大小没有显著影响。理论上,由于瑞士结核病患病率较低,结核菌素试验的阳性预测值较小。根据我们的数据,估计瑞士15岁儿童的最大感染率为0.91%(未接种者为2.48%),外国出生的学龄儿童为2.54%(未接种者为9.77%)。这些比率高于先前研究推断的比率,与其他工业化国家的数据相当。它们不支持瑞士改变卡介苗接种政策,自1987年以来,瑞士仅要求来自结核病高流行国家的儿童接种卡介苗。

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