在成年人中查潜伏性肺结核感染:美国预防服务工作组建议声明
, Carol M Mangione1, Michael J Barry2
1University of California, Los Angeles.
JAMA
|May 2, 2023
概括
在高风险成年人中进行潜伏性结核病感染 (LTBI) 查在预防活跃结核病方面具有适度的益处. 美国预防服务工作组建议采用这种查方法,以获得更好的公共卫生结果.
科学领域:
- 公共卫生
- 预防医学
- 传染病流行病学
背景情况:
- 结核病 (TB) 仍然是美国可预防的重要疾病,包括传染性活跃结核病和无症状潜伏性结核病感染 (LTBI).
- 据估计,多达1300万美国人患有LTBI,可能会发展为活跃的疾病,强调需要有效的查和管理策略.
- 结核病发病率受健康的社会决定因素的影响,强调了与地理和住宿有关的差异.
研究的目的:
- 更新2016年关于LTBI查和治疗的建议.
- 在无症状成年人中评估LTBI查测试的准确性.
- 为初级保健机构提供基于证据的指导.
主要方法:
- 美国预防服务工作组 (USPSTF) 委托进行系统审查.
- 这项审查侧重于高风险的无症状成年人中LTBI的查和治疗.
- 测试的准确性是审查的关键组成部分.
主要成果:
- 在增加风险的个体中,对LTBI的查显示了预防活跃结核病的中等净益.
- 据USPSTF发现,这一结论具有中等的确定性.
- 这些发现适用于18岁及以上无症状成年人.
结论:
- USPSTF建议在高风险人群中进行潜伏结核感染 (LTBI) 查.
- 本建议 (B级) 的目的是防止结核病进展为活跃结核病.
- 查是预防结核病的初级保健管理的一个有价值的工具.
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