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结核病产前查:系统性审查和元分析
A J Morton1,2, N Meagher1, G Tonkin-Hill3
1Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, Australia.
IJTLD open
|June 18, 2025
概括
症状查 (SS) 是检测结核病 (TB) 在孕妇中最有效的方法,提供了查 (NNS) 所需的最高产量和最低数量. 虽然可行和可接受,但其较低的正预测值 (PPV) 凸显了对这一群体改善结核病查工具的需求.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 孕产妇健康 孕产妇健康
背景情况:
- 怀孕期间的结核病 (TB) 导致母亲和新生儿的不良后果,是非产妇产妇死亡率的重要原因.
- 在怀孕期间检测结核病的最佳策略尚未确立,因此需要研究有效的查方法.
研究的目的:
- 确定孕妇肺结核 (TB) 疾病的最佳查策略.
- 为了比较产量,需要查的数量 (NNS) 和不同结核病查方法在产前人群中的积极预测值 (PPV).
主要方法:
- 在主要数据库 (Ovid MEDLINE,Embase,Web of Science,CENTRAL) 进行了系统的文献搜索,以寻找有关产前结核病查的研究.
- 用元分析汇集了各种选方法的产量,NNS和PPV估计.
- 用叙事综合来总结二次结果,包括可行性和可接受性.
主要成果:
- 症状查 (SS) 显示,每1000例怀孕总产量为7.26例,明显高于结核素皮肤测试 (TST) 或干扰素释测试 (IGRA) (每1000例5.12).
- 对于TST/IGRA,SS的查所需数 (NNS) 较低,为138,而TST/IGRA则为1667.
- 对于SS的综合正预测值 (PPV) 为3.85%,远高于TST/IGRA的<0.01%,尽管仍然表明需要改进.
结论:
- 目前,症状查 (SS) 是对孕妇结核病检测的最佳方法,因为其产量高,NNS低,成本效益高,可行性高,可接受性高.
- 尽管有优点,SS的低PPV强调了开发和实施专门针对孕妇群体量身定制的结核病查工具的必要性.
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