在一个实施推结核病控制要素的社区中,Mycobacterium结核病的传播
D P Chin1, C M Crane, M Y Diul
1Tuberculosis Control Branch and Microbial Disease Laboratory, California Department of Health Services, Berkeley, USA. chind@chn.wpro.who.int
JAMA
|June 24, 2000
概括
持续的Mycobacterium结核病传播导致结核病 (TB),即使有控制措施. 早期诊断和更好的接触者识别对于预防结核病的发展至关重要.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 结核病 (TB) 仍然是美国的公共卫生问题,尽管有控制努力.
- 结核菌菌的传播仍在继续,导致新的疾病病例.
研究的目的:
- 鉴定特定的M. tuberculosis菌株导致结核病发展的主要原因.
- 了解一个拥有结核病控制措施的社区内的传播动态.
主要方法:
- 一项以人口为基础的分子流行病学研究在旧金山湾区的一个城市社区进行.
- 基因型和流行病学联系在1996-1997年间确定了73例由单一的M.结核病菌株引起的结核病例.
主要成果:
- 鉴定到的M.结核菌株导致了该社区33%的结核病例.
- 疾病发展的关键因素包括无法识别接触者 (53%),延迟源病例诊断 (27%) 和接触者评估/治疗问题 (18%).
- 大多数感染 (96%) 发生在诊断前两年内.
结论:
- 有效的结核病控制需要更早的患者诊断和更彻底的接触者识别.
- 即使在已建立结核病控制计划的社区,M.结核病的持续传播仍然存在.
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