在美国境外出生的人群中结核病
Kevin P Cain1, Stephen R Benoit, Carla A Winston
1Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E-10, Atlanta, GA 30333, USA. kcain@cdc.gov
JAMA
|July 24, 2008
概括
外国出生的个人患结核病 (TB) 的比例更高,特别是在撒哈拉以南非洲和东南亚. 将结核病培养添加到海外查中可以改善最近进入美国的新移民的检测.
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:
- 在2006年,外国出生的个人占美国结核病 (TB) 病例的57%.
- 现有的结核病控制策略对于这种高风险人群来说是不够的.
- 在外国出生的人群中,活跃结核病和潜伏结核病感染的显著水平仍然存在.
研究的目的:
- 评估外国出生人口的结核病和耐药结核病风险.
- 评估将结核病文化纳入美国移民海外查的影响.
- 确定结核病检测的高风险原产国和时间框架.
主要方法:
- 描述性流行病学分析美国境外出生的结核病例 (2001-2006).
- 根据美国入境以来的时间,原籍国和入境时的年龄对结核病例率的分层划分.
- 对抗结核病药物耐药性模式和早期结核病例特征的分析.
主要成果:
- 在外国出生的人群中报告了46,970例结核病例 (2001年至2006年);28%是新入境者.
- 结核病发病率仍然高于美国出生率,即使在抵达后的20年.
- 53%的病例起源于撒哈拉以南非洲和东南亚;在某些群体中发现高异化物耐药性.
结论:
- 来自撒哈拉以南非洲和东南亚的个体显示了潜在结核病感染检测的高收益率.
- 针对性的查和治疗策略对于外国出生的人口至关重要.
- 通过结核病培养来加强海外查可能会改善早期检测和控制.
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