移民中潜伏结核病的查-现状和未来的挑战
Eskild Petersen1, Seif Al-Abri2, Amina Al-Jardani3
1PandemiX Center of Excellence, Roskilde University, Roskilde, Denmark; European Society for Clinical Microbiology and Infectious Diseases Task Force for Emerging Infections, Basel, Switzerland; International Society for Infectious Diseases, Boston, MA, USA.
来自高结核病发病率国家的移民可以在迁移后重新激活潜伏的结核病. 查和预防性治疗是有益的,但缺乏标准化的协议,以获得最佳的公共卫生结果.
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
- 移民 卫生 移民 卫生
背景情况:
- 结核病 (TB) 仍然是一个全球卫生挑战,不成比例地影响高发病率地区.
- 国际移民模式需要了解低发病率国家的疾病传播动态.
- 潜伏结核病的重新激活是移民群体的一个重大问题.
研究的目的:
- 评估来自结核病发病率高的国家移民对结核病发病率低目的地国家的活跃结核病例的贡献.
- 审查关于潜在结核病再激活作为移民人口结核病发病率的主要驱动因素的证据.
- 评估当前针对移民的结核病查和预防治疗计划的有效性和挑战.
主要方法:
- 对现有文献和选计划进行叙事审查.
- 对潜在结核病的入境前后查策略的分析.
- 检查诊断工具,如干扰素释放试验 (IGRA) 和结核素皮肤试验 (TST).
主要成果:
- 查程序使用IGRA或TST来检测潜在的结核病.
- 预防性治疗选择包括异化单一治疗或与里法素/里法丁联合治疗.
- 关于无症状个体的预防治疗的伦理考虑在各种查背景下进行讨论.
结论:
- 实施对来自结核病发病率高的国家的移民进行查显然是有益的.
- 在查协议,后续程序和治疗方案方面存在显著的标准化缺失.
- 需要进一步协调国际指导方针,以优化移民人口中的结核病控制.
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