Calder L, Priest P
Community Services, Auckland Healthcare.
N Z Med J. 1996 May 10;109(1021):164-7.
To describe the recent epidemiology of tuberculosis in Auckland and the outcome of contact investigations.
Routine public health data were used to review the experience of tuberculosis (TB) in the Auckland region during a twelve month period in 1992-3.
There were 152 cases, an age-standardised rate of 2.7 per 100,000 for Europeans, 37.8 for Maori, 70.9 for Pacific Island Polynesians and 131.3 for other ethnic groups. Fifty-two (35%) were born in New Zealand; 46 (31%) in Asia; 44 (30%) in the Pacific Islands. Forty-seven percent of foreign-born cases (28% of all cases) arrived in New Zealand in the 4 years preceding their notification. Forty-one per cent of cases appear not to have been diagnosed until 3 months or longer after the onset of their symptoms. Fifteen cases (including three sputum smear-positive cases) took 4 weeks or longer from diagnosis to be notified to the public health office. 12.5% of isolates were not notified. Two per cent of the 1079 contacts examined had tuberculosis.
This review highlights the need for tuberculosis and the importance of timely comprehensive screening of immigrants from high incidence countries; reducing the interval between onset of symptoms and diagnosis; improving the notification rate of tuberculosis; and focusing contact investigation on those at highest risk.
描述奥克兰近期结核病的流行病学情况以及接触者调查的结果。
利用常规公共卫生数据回顾了1992 - 1993年12个月期间奥克兰地区结核病的情况。
共有152例病例,欧洲人的年龄标准化发病率为每10万人2.7例,毛利人为37.8例,太平洋岛波利尼西亚人为70.9例,其他族裔为131.3例。52例(35%)出生在新西兰;46例(31%)出生在亚洲;44例(30%)出生在太平洋岛屿。47%的外国出生病例(占所有病例的28%)在确诊前4年抵达新西兰。41%的病例直到症状出现3个月或更长时间后才被诊断出来。15例病例(包括3例痰涂片阳性病例)从诊断到向公共卫生办公室报告用时4周或更长时间。12.5%的分离株未被报告。在接受检查的1079名接触者中,2%患有结核病。
本综述强调了结核病防控的必要性以及及时对来自高发病国家的移民进行全面筛查的重要性;缩短症状出现到诊断的间隔时间;提高结核病的报告率;并将接触者调查重点放在高危人群上。