Denic L, Lucet J C, Pierre J, Deblangy C, Kosmann M J, Carbonne A, Bouvet E
Hospital Epidemiology Unit, Bichat-Claude Bernard Hospital, Paris, France.
Eur J Epidemiol. 1998 Jun;14(4):339-42. doi: 10.1023/a:1007457523455.
The aim of this study was to evaluate completeness of tuberculosis notification in Bichat Claude-Bernard University Hospital and to evaluate whether misclassification of atypical mycobacterial infection could have contributed to the inaccuracy of tuberculosis notification. Data from Microbiology Laboratory of the hospital and statutory notifications were compared. From 1 January 1994 to 31 December 1995, 299 tuberculosis cases were diagnosed in the Microbiology Laboratory and 316 cases were notified as tuberculosis. Notification rate for laboratory-documented tuberculosis was 57.5%, was significantly higher in cases with positive acid fast bacilli smear (75%) than without this feature (45%) and was similar in HIV-positive (59.4%) and HIV-negative (63.5%) patients. Among notified cases, diagnosis was established by laboratory proofs in only 54.4% and by clinical signs in 45.6%. Three cases with positive smear and culture growing atypical mycobacteria were wrongly notified. Notification of laboratory-documented tuberculosis was higher than that observed in a previous study in the same hospital, suggesting that the rise of tuberculosis incidence reported in our country could be partially artificial. Nevertheless, extent of notification remains insufficient and needs to be improved by combining microbiological data with current system of notification.
本研究的目的是评估比夏特·克劳德-伯纳德大学医院结核病报告的完整性，并评估非典型分枝杆菌感染的错误分类是否可能导致结核病报告的不准确。将医院微生物实验室的数据与法定报告进行了比较。1994年1月1日至1995年12月31日，微生物实验室诊断出299例结核病病例，316例被报告为结核病。实验室确诊的结核病报告率为57.5%，抗酸杆菌涂片阳性的病例（75%）明显高于无此特征的病例（45%），在艾滋病毒阳性（59.4%）和艾滋病毒阴性（63.5%）患者中相似。在报告的病例中，仅54.4%通过实验室证据确诊，45.6%通过临床症状确诊。3例涂片阳性且培养出非典型分枝杆菌的病例被错误报告。实验室确诊的结核病报告率高于该医院此前一项研究中的报告率，这表明我国报告的结核病发病率上升可能部分是人为因素。然而，报告范围仍然不足，需要通过将微生物学数据与当前报告系统相结合来加以改善。
