对印度结核病活体病例的系统审查和元分析
Tushar Garg1, Lelia H Chaisson2, Fahd Naufal3
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
The Lancet regional health. Southeast Asia
|June 29, 2023
概括
印度结核病 (TB) 活跃病例发现 (ACF) 需要更好的准. 证据表明,艾滋病毒感染者和部落人口产生了最多的病例,但不同的策略和高损失后跟踪阻碍了进展.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染病控制和控制传染病
背景情况:
- 积极病例发现 (ACF) 是印度国家结核病 (TB) 政策的核心.
- 不同的ACF策略在常规编程中存在实施挑战.
- 需要进行全面的审查,以描述印度的ACF,并评估其有效性.
研究的目的:
- 描述ACF在印度的结核病策略.
- 评估ACF在不同风险组,选地点和标准上的产量.
- 在查和诊断期间估计后续损失 (LTFU).
主要方法:
- 在PubMed,EMBASE,Scopus和Cochrane图书馆的文献搜索 (2010年11月 - 2020年12月).
- 计算所需查 (NNS) 的加权平均数,按风险组,位置和策略分层分层.
- 查和预诊断LTFU比例的估计;使用AXIS工具进行偏差风险评估.
主要成果:
- 包括来自印度的45项研究,主要来自南部和西部地区.
- 在艾滋病毒感染者 (21),部落人口 (50) 和家庭接触者 (50) 中观察到的NNS最低.
- 基于设施的查和世卫组织的症状查显示了较低的NNS;中位数LTFU为6% (查) 和9.5% (预诊断).
结论:
- 在印度,有效的ACF需要特定的背景设计和更强大的证据基础.
- 目前的证据不足以在印度多样化的环境中针对ACF编程.
- 基于证据的ACF实施对于实现国家结核病病例发现目标至关重要.
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