发现和治疗结核病和潜伏感染,在全人口范围内发现结核病消除的活跃病例
Mikaela Coleman1,2, Thu-Anh Nguyen3,4, Boi Khanh Luu3
1WHO Collaborating Centre for Tuberculosis and the Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, Sydney, NSW, Australia.
Frontiers in medicine
|November 1, 2023
概括
针对性结核病例发现增加了检测,但缺乏经过证明的流行病影响. 需要一项全面的战略来应对活跃和潜伏的结核病,以实现可持续的消除.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 全球健康 全球健康
背景情况:
- 不被检测到的结核病的高率需要改进的病例发现策略.
- 世界卫生组织 (WHO) 建议在高风险群体中针对性发现活跃病例 (ACF).
- 目前的ACF战略显示,疫情影响有限,并没有完全解决潜在的结核病储存.
研究的目的:
- 评估针对性结核病例发现与全人口发现活跃病例的流行病影响.
- 探讨结合活跃疾病和潜伏感染管理的整体战略的作用,以消除结核病.
- 评估敏感,无症状查在实现可持续结核病控制方面的潜力.
主要方法:
- 对全人口ACF有效性的历史数据的审查.
- 分析当前的ACF策略及其局限性.
- 整体案例调查方法的概念框架.
主要成果:
- 有针对性的ACF增加了病例检测,但其在人口层面对传播的影响尚未被证明.
- 全人口ACF有历史上的先例在高发病率环境中中断传输.
- 潜在的结核病感染使消除努力复杂化,需要综合管理.
结论:
- 一个整体的战略,整合活跃结核病例的发现和潜伏感染的治疗,可能是最佳的可持续消除.
- 敏感的,无症状的查与治疗和预防相结合至关重要.
- 为了全球消除结核病,需要使用现有工具进行大胆的长期战略.
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