TB Incidence in an Adolescent Cohort in South Africa
TB Incidence in an Adolescent Cohort in South Africa
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DOI：
10.1371/journal.pone.0059652
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发表时间：
2013-03-22
期刊：
影响因子：
3.7
通讯作者：
Hussey, Gregory Dudley
中科院分区：
文献类型：
--
作者：
Mahomed, Hassan;Ehrlich, Rodney;Hussey, Gregory Dudley
背景：结核病（TB）是全球主要的公共卫生问题。对于青少年中结核病的发病率知之甚少，青少年是新结核病疫苗的拟议目标群体。我们进行了一项研究，以确定南非结核病高负担地区一群在校青少年的结核病发病率和结核病危险因素。方法：我们招募了南非伍斯特高中的 12 至 18 岁青少年。收集人口统计和临床信息，进行结核菌素皮试 (TST)，并抽血进行基线 QuantiFERON TB Gold 测定。结核病筛查是在入学后长达 3.8 年内的随访和公共部门结核病诊所登记册监测中进行的。结果：共有 6,363 名青少年入学（目标学校人口的 58%）。在随访期间，检测到 67 例细菌学确诊的结核病病例，总发病率为每 100 人年 0.45 例（95% 置信区间 0.29-0.72）。黑人或混血种族、母亲受过小学或以下教育或未知、基线 QuantiFERON 检测呈阳性和基线 TST 呈阳性是调整分析中结核病的显着预测因素。结论：在高负担环境中发现的青少年结核病发病率将有助于结核病疫苗开发人员计划在该人群中进行临床试验。潜伏性结核感染和低社会经济地位是结核病的预测因素。
Background: Tuberculosis (TB) is a major public health problem globally. Little is known about TB incidence in adolescents who are a proposed target group for new TB vaccines. We conducted a study to determine the TB incidence rates and risk factors for TB disease in a cohort of school-going adolescents in a high TB burden area in South Africa.Methods: We recruited adolescents aged 12 to 18 years from high schools in Worcester, South Africa. Demographic and clinical information was collected, a tuberculin skin test (TST) performed and blood drawn for a QuantiFERON TB Gold assay at baseline. Screening for TB cases occurred at follow up visits and by surveillance of registers at public sector TB clinics over a period of up to 3.8 years after enrolment.Results: A total of 6,363 adolescents were enrolled (58% of the school population targeted). During follow up, 67 cases of bacteriologically confirmed TB were detected giving an overall incidence rate of 0.45 per 100 person years (95% confidence interval 0.29-0.72). Black or mixed race, maternal education of primary school or less or unknown, a positive baseline QuantiFERON assay and a positive baseline TST were significant predictors of TB disease on adjusted analysis.Conclusion: The adolescent TB incidence found in a high burden setting will help TB vaccine developers plan clinical trials in this population. Latent TB infection and low socio-economic status were predictors of TB disease.