扩大无症状,社区范围的查,以消除全球结核病:机遇,挑战和历史教训
Hanif Esmail1, Cecily Miller2, Dennis Falzon2
1WHO Collaborating Centre for Tuberculosis Research and Innovation, UCL Centre for Global Tuberculosis Research, Institute for Global Health, University College London, London, United Kingdom; MRC Clinical Trials Unit at University College London, London, United Kingdom; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine and Department of Pathology, University of Cape Town, Cape Town, South Africa.
概括
全球结核病 (TB) 发病率保持不变,数百万未被诊断的病例被遗漏. 无症状查,如胸部X射线,对于早期检测和减少结核病传播至关重要.
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:
- 全球结核病 (TB) 发病率在21世纪变化很小.
- 尽管病例报告增加,但每年仍有数百万名结核病患者未被诊断和未被接触.
- 未被诊断的结核病例往往没有症状,阻碍了传统的检测方法.
研究的目的:
- 突出症状无诊断查的潜力,以识别未诊断的结核病.
- 讨论扩大无症状查计划的挑战和机遇.
- 从过去的结核病查工作中吸取教训.
主要方法:
- 审查当前全球结核病查实践.
- 分析症状无关查 (例如,胸部X射线) 的有效性.
- 过去人口层面查计划的历史案例研究分析.
主要成果:
- 无症状查有效地识别出未被诊断的,潜在的传染性结核病患者.
- 目前全球在症状无关查方面的努力不足以影响传播.
- 20世纪中叶的历史性胸部X射线查有助于低结核负担国家结核病的减少.
结论:
- 显著扩大无症状查是必要的,以改善结核病治疗覆盖率和中断传播.
- 克服政治,金融和卫生系统的挑战对于成功实施至关重要.
- 从过去的大规模查举措中吸取的经验教训为当前的策略提供了宝贵的见解.
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