Tuberculosis Transmission and Use of Methamphetamines in Snohomish County, WA, 1991-2006
Tuberculosis Transmission and Use of Methamphetamines in Snohomish County, WA, 1991-2006
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DOI：
10.2105/ajph.2009.162388
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发表时间：
2010-12-01
影响因子：
12.7
通讯作者：
Oeltmann, John E.
中科院分区：
文献类型：
--
作者：
Pevzner, Eric S.;Robison, Susan;Oeltmann, John E.
目的调查一起聚集性肺结核病例在华盛顿斯诺霍米什县使用甲基苯丙胺的人中的病例，以确定爆发的程度，检查甲基苯丙胺的使用是否有助于结核病的传播，并实施预防进一步感染的策略。外展策略包括寻找接触者的新方法和促进发现、筛查和治疗结核病患者及其感染接触者的激励和促进系统结果我们诊断并完成了10例结核病患者的治疗，9例成人患者中有8例及其67%的成人接触者报告使用甲基苯丙胺，372例接触者中有319例（858%）80例（25.1%）感染，71例（88.8%）因潜伏感染开始治疗，57例（80.3%）结论将结核病控制外展纳入激励和促进因素的协作方法导致患者和感染接触者的治疗依从性和完成率很高，结核病控制项目应与解决成瘾问题的药物滥用方案，克服与药物滥用相关的治疗障碍，治疗结核病并预防持续传播（美国公共卫生杂志2010 100 2481-2486 doi 10 2105/AJPH 2009 162388）
Objectives We investigated a cluster of tuberculosis (TB) cases among persons using methamphetamines in Snohomish County Washington to determine the extent of the outbreak examine whether methamphetamine use contributed to TB transmission and implement strategies to prevent further infectionsMethods We screened contacts to find and treat persons with TB disease or infection We then formed a multidisciplinary team to engage substance abuse services partners and implement outreach strategies including novel methods for finding contacts and a system of incentives and enablers to promote finding screening and treating patients with TB and their infected contactsResults We diagnosed and completed treatment with 10 persons with TB disease Eight of 9 adult patients and 67% of their adult contacts reported using methamphetamines Of the 372 contacts 319 (85 8%) were screened 80 (25 1%) were infected 71 (88 8%) started treatment for latent infection and 57 (80 3%) completed treatment for latent infectionConclusions Collaborative approaches integrating TB control outreach in centives and enablers resulted in high rates of treatment adherence and completion among patients and infected contacts TB control programs should collaborate with substance abuse programs to address addiction overcome substance abuse-related barriers to treatment treat TB and prevent ongoing transmission (Am J Public Health 2010 100 2481-2486 doi 10 2105/AJPH 2009 162388)