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活跃结核病例查找对马拉维布兰泰尔病例报告的影响:基于社区的集群随机试验 (SCALE)
Helena R A Feasey1, McEwen Khundi2, Rebecca Nzawa Soko3
1London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLOS global public health
|December 5, 2023
概括
活跃结核病例查找 (ACF) 没有增加布兰泰尔的病例报告,马拉维,尽管残留疾病. 未来的努力应优先考虑有针对性的宣传和需求创造,以及基于设施的结核病查.
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
- 临床试验 临床试验
背景情况:
- 活跃病例查找 (ACF) 旨在识别未被诊断的结核病例,这对于控制结核病发病至关重要.
- 失踪的数以百万计的人.
- 马拉维的布兰泰尔区在高额未诊断的结核病估计后,已经看到密集的ACF实施.
研究的目的:
- 评估门对门ACF对马拉维布兰泰尔结核病例报告的影响.
- 为了比较ACF和标准护理 (SOC) 之间的细菌学确认结核病例报告率 (CNRs).
- 评估干预前流行调查对SOC手臂中CNR的影响.
主要方法:
- 马拉维布兰泰尔的一个集群随机试验,比较门到门的ACF与SOC.
- 主要结局:细菌学证实结核病的91天CNR比率.
- 二次结果:所有结核病登记和非ACF诊断的91天CNR比率;调查影响的中断时间序列分析.
主要成果:
- 对于细菌学确认的结核病 (1.12),所有结核病登记 (0.93),或非ACF诊断 (0.86) 的ACF和SOC臂之间的91天CNR比率没有显著差异.
- 干预前调查显示,对SOC的CNR没有影响.
- 剩余未诊断的结核病被估计为每10万人口中的150例.
结论:
- 密集的门对门ACF在这个环境中没有增加结核病通知,这可能是由于ACF之前的努力和结核病负担的下降.
- 在类似的背景下,未来的ACF战略应该包括有针对性的宣传,需求创造和加强基于设施的选.
- 该研究强调了结核病控制计划中需要适应性策略的必要性.
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