ミネソタ州のインドとネパールからのチベット移民の結核,1992-1995年

D H Truong¹, L L Hedemark, J K Mickman

¹Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis 55454-1015, USA.

JAMA

|March 5, 1997

まとめ

ミネソタ州のチベット系移民の間で結核 (TB) 感染症はほぼ普遍的であり,ほとんどのケースではスクリーニングが欠けています. 密接なフォローアップは,特に結核の病歴のある人にとって非常に重要です.

科学分野:

感染症感染症は感染症です.
公衆衛生は公衆衛生である.
移住健康移民

背景:

チベットの移民は,移住後の結核 (TB) の高いリスクに直面しています.
スクリーニングプロトコルは,リスク集団における結核の特定と管理を目的としています.

研究の目的:

ミネソタ州に到着するチベット系移民の結核検診結果を評価するため.
活性結核症例の検出における初期スクリーニングの有効性を評価する.

主な方法:

191人のチベット人移民の医療検査を受けた後回顧的なコホート研究.
結核の皮膚検査結果,活性結核の発生,治療結果の分析.
スクリーニングデータと臨床診断および薬物耐性プロファイルの比較.

主要な成果:

チベットの移民の98%が結核皮膚検査で陽性であり,他の難民集団よりも大幅に高かった.
アクティブな結核はチベット人の8.4%で診断され,最初のスクリーニングで31%のカルチャーネガティブでした.
多剤耐性結核 (MDR TB) は19%の症例で特定され,初期スクリーニングで見逃されたことが多い.

結論:

ミネソタ州のチベット系移民の間で結核の感染が非常に多い.
初期スクリーニングは,この集団における大部分の活性結核症例を検出するのに不十分です.
結核病歴のある個人は,最初のネガティブな培養でも,厳格なフォローアップを必要とします.

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