Buskin S E, Gale J L, Weiss N S, Nolan C M
Department of Epidemiology, University of Washington, Seattle.
Am J Public Health. 1994 Nov;84(11):1750-6. doi: 10.2105/ajph.84.11.1750.
Tuberculosis has become a resurgent public health problem in the United States. Because resources are limited, control programs frequently must target populations at greatest risk. The purpose of the study was to examine risk factors for tuberculosis in adults.
In King County, Washington State, from 1988 through 1990, the characteristics of patients with tuberculosis were compared with census data, and a case-control study was conducted. Self-administered questionnaires were completed by 151 patients with active tuberculosis and 545 control subjects.
Infection with the human immunodeficiency virus, non-White race/ethnicity, and foreign birthplace were each associated with a sixfold or greater increase in risk. Each of the following was associated with at least a doubled risk: history of selected underlying medical conditions; low weight for height; low socioeconomic status; and age 70 years or older. Men had 1.9 times the risk of women, smokers of 20 years' or more duration had 2.6 times the risk of nonsmokers, and heavy alcohol consumers had 2.0 times the risk of nondrinkers.
Intervention targeting easily identified groups may be an effective way to reduce the incidence of tuberculosis.
结核病在美国已再度成为一个公共卫生问题。由于资源有限,防控项目常常必须针对风险最高的人群。本研究的目的是调查成年人患结核病的风险因素。
1988年至1990年期间,在华盛顿州金县,将结核病患者的特征与人口普查数据进行比较,并开展了一项病例对照研究。151名活动性结核病患者和545名对照对象完成了自行填写的调查问卷。
感染人类免疫缺陷病毒、非白人种族/族裔以及出生于国外均与风险增加六倍或更多相关。以下各项中的每一项都与风险至少增加一倍相关:特定基础疾病史;身高对应的体重偏低;社会经济地位低下;以及70岁或以上年龄。男性的风险是女性的1.9倍,吸烟20年或更长时间的人风险是非吸烟者的2.6倍,大量饮酒者的风险是非饮酒者的2.0倍。
针对易于识别的群体进行干预可能是降低结核病发病率的有效方法。