在南非金矿社区的结核控制和分子流行病学
P Godfrey-Faussett1, P Sonnenberg, S C Shearer
1Department of Medicine, University Teaching Hospital, Lusaka, Zambia. peter.godfrey-faussett@lshtm.ac.uk
Lancet (London, England)
|September 29, 2000
概括
大多数黄金矿工肺结核病例源于社区传播,而不是进口感染. 以前治疗失败的个体是持续肺结核传播的关键,需要改进控制策略.
科学领域:
- 流行病学 流行病学
- 分子生物学分子生物学
- 公共卫生 公共卫生
背景情况:
- 金矿工的结核病发病率很高.
- 在采矿社区,结核病传播的起源 (进口或本地) 尚不清楚.
- 了解传播动态对于有效的结核病控制战略至关重要.
研究的目的:
- 调查社区传播对金矿工结核病发病率的贡献.
- 确定与结核病传播集群相关的风险因素.
主要方法:
- 一个前性的,基于人口的研究,结合了分子和传统的流行病学.
- IS6110 DNA指纹被用于定义结核病传播集群.
- 结核病群和非群结核病例之间的风险因素进行了比较.
主要成果:
- 至少50%的结核病例是社区内传播的结果.
- 以前的治疗失败与在传染集群中存在的情况有显著的关联.
- 与药物敏感菌株相比,多药耐药结核病的聚集可能性较小.
结论:
- 持续的社区传播,而不是进口病例,在这个金矿环境中推动了结核病流行.
- 以前治疗失败的个体是正在进行的结核病传播的重要来源.
- 目前世界卫生组织的治愈率目标不足以阻止这种高风险人群中的结核病传播.
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