Nelson K R, Bui H, Samet J H
Evans Department of Medicine, Boston Medical Center, Massachusetts, USA.
Am J Med. 1997 May;102(5):435-40. doi: 10.1016/S0002-9343(97)89443-0.
To determine how the medical and social profile of a particular special population, Vietnamese immigrants, should be used to tailor screening protocols that differ from those designed for the general population.
A consecutive series of Vietnamese immigrants living in the United States for less than 6 months were evaluated by interviewer-administered standardized questionnaire and medical record review. A total of 99 new Vietnamese immigrants (47 women and 52 men) aged 19 to 71 years presenting for primary care to two neighborhood health centers between October 1994 and June 1995 were identified. Data collected included smoking status, alcohol use (CAGE questionnaire), depression (Vietnamese Depression Scale [VDS]), PPD status, stool ova and parasites, hepatitis B and syphilis serologies.
Overall, 32% were smokers and significantly more men than women smoked (54% vs. 9%) (P < .00001). Although 24% of patients used alcohol, none responded positively to any of the CAGE questions. Using the VDS, 17% (17 of 99) were depressed; age 40 and older was the only sociodemographic factor associated with depression (P < .00001). Ova or parasites were found in 51% (41 of 80), and 63% of those infected (26 of 41) required treatment for pathogenic infections. Seventy percent (66 of 94) tested positive on the tuberculin skin test (PPD), and antituberculous medication was recommended in 39% (37 of 94). Eighty-three percent (80 of 96) had been exposed to hepatitis B, and 14% (13 of 96) were chronic hepatitis B carriers.
Caring for special populations provides an opportunity to institute appropriate unique screening tests not recommended for the general population. In the case of new Vietnamese immigrants, routine screening protocols should include the following: testing for tuberculosis by PPD, stool ova and parasite examinations, hepatitis B serologies, and assessment for depression and smoking status. The CAGE questionnaire may not be an effective instrument for detecting alcohol abuse in this particular population.
确定如何利用特定特殊人群（越南移民）的医学和社会特征来制定与针对普通人群设计的筛查方案不同的筛查方案。
通过访员管理的标准化问卷和病历审查，对连续一系列在美国居住时间少于6个月的越南移民进行评估。1994年10月至1995年6月期间，在两家社区卫生中心接受初级保健的99名年龄在19至71岁之间的新越南移民（47名女性和52名男性）被纳入研究。收集的数据包括吸烟状况、饮酒情况（CAGE问卷）、抑郁情况（越南抑郁量表[VDS]）、结核菌素试验状态、粪便虫卵和寄生虫检查、乙肝和梅毒血清学检查。
总体而言，32%的人吸烟，吸烟的男性显著多于女性（54%对9%）（P<.00001）。虽然24%的患者饮酒，但对CAGE问卷的任何问题均无阳性回答。使用VDS评估，17%（99人中的17人）存在抑郁；年龄40岁及以上是与抑郁相关的唯一社会人口统计学因素（P<.00001）。80人中有51%（41人）发现虫卵或寄生虫，其中63%（41人中的26人）的感染者因致病性感染需要治疗。94人中有70%（66人）结核菌素皮肤试验（PPD）呈阳性，94人中有39%（37人）被建议接受抗结核药物治疗。96人中有83%（80人）曾接触过乙肝，96人中有14%（13人）为慢性乙肝携带者。
照顾特殊人群提供了一个机会，可以开展一些针对普通人群不建议进行的适当的独特筛查测试。对于新的越南移民，常规筛查方案应包括以下内容：PPD检测结核病、粪便虫卵和寄生虫检查、乙肝血清学检查，以及评估抑郁和吸烟状况。CAGE问卷可能不是检测该特定人群酒精滥用的有效工具。
