报告的结核病症状:一种不充分的疾病状态分类器
Nicky McCreesh1, Peter MacPherson1,2,3, José Victor Bortolotto Bampi4
1TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom.
概括
通过症状区分结核病 (TB) 对公共卫生来说是不可靠的. 研究人员主张对自我报告的症状采取客观措施,以更好地分类疾病严重程度并指导治疗.
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:
- 由于流行调查结果,对无症状结核病 (aTB) 和症状结核病 (sTB) 的兴趣日益增加.
- 世卫组织的一份报告提出了aTB/sTB的具体策略,包括基于sTB的治疗调查和发病率估计.
研究的目的:
- 评估支持使用无症状结核病 (aTB) 和症状结核病 (sTB) 病例定义进行监测,负担估计和临床管理的证据.
- 倡导在结核病研究中更客观地测量疾病严重程度.
主要方法:
- 分析自我报告的症状作为结核病疾病状态的分类器.
- 评估影响症状报告的背景和采访者变异性的评估.
- 基于症状的证据与疾病严重程度的客观指标的证据审查.
主要成果:
- 自我报告的症状是结核病疾病状态的不充分和可变分类器.
- 症状报告在很大程度上受到背景和采访者变化的影响.
- 结核病症状可能有其他原因,使其作为唯一指标的使用变得复杂.
结论:
- 提出使用aTB/sTB病例定义的建议缺乏足够的证据来证明可靠的公共卫生应用.
- 需要更强大,客观的,反映病理生理学的措施来评估结核病的严重程度.
- 未来的研究应该优先考虑客观的严重程度指标,而不是基于症状的分类,以便全面了解结核病的谱.
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