在家庭暴露于肺结核的成年人中查无症状结核病:前性观察队列研究
Simon C Mendelsohn1, Humphrey Mulenga1, Michele Tameris1
1South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
The Lancet. Global health
|October 18, 2025
概括
在家庭接触者中,大多数结核病例无症状,超过40%的病例缺少胸部X射线. 症状和胸部X射线查可能会低估结核病在流行地区的流行率.
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:
- 社区流行调查经常将超过一半的结核病 (TB) 病例归类为无症状.
- 结核病患者的家庭接触者是识别未诊断结核病的关键人群.
- 查策略需要有效地识别无症状结核病.
研究的目的:
- 评估南非家庭接触者肺结核的症状和胸部X射线检查的诊断产量.
- 为了确定这个群体中无症状结核病的患病率和特征.
主要方法:
- 在南非对979名结核病患者的家庭接触者的前性观察队列研究.
- 查包括症状评估,胸部放射,唾液显微镜,Xpert Ultra和液体培养.
- 流行性结核病在微生物学上得到证实;无症状结核病被定义为没有相容症状的确诊结核病.
主要成果:
- 5.2% (51/979) 的接触者患有肺结核,其中82.4% (42/51) 没有症状.
- 无症状结核病的胸部X射线图敏感度为56.1% (23/41).
- 综合症状和胸部放射性查对所有流行性结核病的敏感度为64.0% (32/50).
结论:
- 在家庭接触者中大多数结核病例是无症状的.
- 仅仅进行胸部放射性查不足以检测无症状结核病.
- 目前的社区流行调查依赖于症状和胸部X射线,可能大大低估了结核病的流行率.
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