Community-based active case-finding interventions for tuberculosis: a systematic review.
Community-based active case-finding interventions for tuberculosis: a systematic review.
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以社区为基础的积极结核病病例发现干预措施：一项系统评价。
DOI：
10.1016/s2468-2667(21)00033-5
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发表时间：
2021-05
期刊：
影响因子：
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通讯作者：
MacPherson P
中科院分区：
文献类型：
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作者：
Burke RM;Nliwasa M;Feasey HRA;Chaisson LH;Golub JE;Naufal F;Shapiro AE;Ruperez M;Telisinghe L;Ayles H;Corbett EL;MacPherson P
以社区为基础的积极的病例发现干预措施可能比标准病例检测发现和治疗更多的结核病患者。我们旨在评估积极的病例发现干预措施是否会影响更广泛社区的结核病流行病学。我们通过检索PubMed、Embase、Scopus和科克伦图书馆，对暴露于和未暴露于主动病例发现干预措施的人群之间的结核病病例报告率、结核病患病率或儿童结核病感染患病率或发病率进行了系统评价。我们纳入了1980年1月1日至2020年4月13日期间以英语发表的研究。包括在一般人群、被认为是结核病高危人群和封闭环境中进行主动病例发现的研究，而在卫生保健机构、家庭接触者或仅儿童中进行结核病筛查的研究以及筛查人数少于1000人的研究则被排除在外。为了估计有效性，我们提取或计算了病例报告率、结核病患病率和儿童结核病感染的发病率或患病率，并比较了暴露于或不暴露于积极病例发现干预措施的组之间这些结果的比率。筛选了27883篇摘要，988篇文章进行了全文审查。28项研究提供了结核病病例报告分析数据，9项研究提供了结核病患病率数据，2项研究提供了儿童结核病感染发生率或患病率数据。在南非和赞比亚的一项随机分组试验中，基于社区动员和痰液脱落的积极病例发现干预措施并不影响结核病患病率，而在越南的一项随机分组试验中，基于每个人痰结核病检测的积极病例发现干预措施降低了社区结核病患病率。我们发现了不一致的低质量证据，表明积极的病例发现可能会增加具有结核病结构性风险因素的人群中报告的结核病病例数。以社区为基础的结核病主动病例发现可能有效地改变结核病流行病学，从而改善人口健康，如果提供高覆盖率和强度。如果可能的话，积极的病例发现项目应该包括一个精心设计的，强大的评估，以促进证据基础，并帮助阐明哪些交付方法和诊断策略是最有效的。世卫组织全球结核病规划。
Community-based active case-finding interventions might identify and treat more people with tuberculosis disease than standard case detection. We aimed to assess whether active case-finding interventions can affect tuberculosis epidemiology in the wider community. We did a systematic review by searching PubMed, Embase, Scopus, and Cochrane Library for studies that compared tuberculosis case notification rates, tuberculosis disease prevalence, or tuberculosis infection prevalence or incidence in children, between populations exposed and unexposed to active case-finding interventions. We included studies published in English between Jan 1, 1980, and April 13, 2020. Studies of active case-finding in the general population, in populations perceived to be at high risk for tuberculosis, and in closed settings were included, whereas studies of tuberculosis screening at health-care facilities, among household contacts, or among children only, and studies that screened fewer than 1000 people were excluded. To estimate effectiveness, we extracted or calculated case notification rates, prevalence of tuberculosis disease, and incidence or prevalence of tuberculosis infection in children, and compared ratios of these outcomes between groups that were exposed or not exposed to active case-finding interventions. 27 883 abstracts were screened and 988 articles underwent full text review. 28 studies contributed data for analysis of tuberculosis case notifications, nine for prevalence of tuberculosis disease, and two for incidence or prevalence of tuberculosis infection in children. In one cluster-randomised trial in South Africa and Zambia, an active case-finding intervention based on community mobilisation and sputum drop-off did not affect tuberculosis prevalence, whereas, in a cluster-randomised trial in Vietnam, an active case-finding intervention based on sputum tuberculosis tests for everyone reduced tuberculosis prevalence in the community. We found inconsistent, low-quality evidence that active case-finding might increase the number of cases of tuberculosis notified in populations with structural risk factors for tuberculosis. Community-based active case-finding for tuberculosis might be effective in changing tuberculosis epidemiology and thereby improving population health if delivered with high coverage and intensity. If possible, active case-finding projects should incorporate a well designed, robust evaluation to contribute to the evidence base and help elucidate which delivery methods and diagnostic strategies are most effective. WHO Global TB Programme.
影响因子：
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作者：
Delva GJ;Francois I;Claassen CW;Dorestan D;Bastien B;Medina-Moreno S;Fort DS;Redfield RR;Buchwald UK
通讯作者：
Buchwald UK