在美国大型综合医疗保健系统中,潜伏结核病感染检测实践
Jennifer H Ku1, Heidi Fischer1, Lei X Qian1
1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
概括
潜在结核病感染 (LTBI) 检测可能会错过高风险个体. 目前的做法需要改进,以更好地针对LTBI进行选,确保识别和测试那些最脆弱的人.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 结核病 (TB) 仍然是一个重大的公共卫生问题,在美国,超过80%的活跃病例源于潜伏结核病感染 (LTBI) 的重新激活.
- 目前的LTBI查实践可能是低效的,可能导致高风险人群的查不足和低风险人群的过度查.
研究的目的:
- 分析当前潜伏结核病感染 (LTBI) 检测实践.
- 为了确定与测试阳性相关的LTBI测试中的差距.
- 了解与LTBI测试和阳性相关的因素.
主要方法:
- 在2008年1月1日至2019年12月31日期间,使用凯泽永久南加州的数据进行了一项回顾性研究.
- 包括18岁或以上的成年人,没有活跃结核病病史.
- 研究了与LTBI测试和LTBI阳性相关的因素.
主要成果:
- 在3,816,884名成年人中,19% (706,367) 接受了LTBI测试,其中9% (60,393) 的测试结果呈阳性.
- 在符合查标准的个人中,只有17% (1211,971人中有210,025人) 接受了测试.
- 诸如男性性别,亚洲/太平洋岛民种族,吸烟,糖尿病,乙型肝炎/乙型肝炎,以及在高结核病率的国家出生在国外等因素增加了对LTBI测试呈阳性但不测试自身的几率.
结论:
- 现有的LTBI测试策略可能无法有效识别高风险个体.
- 进一步的研究和查指南的完善是必要的,以优化对高风险人群的LTBI测试.
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