Contact investigation for tuberculosis: a systematic review and meta-analysis.
Contact investigation for tuberculosis: a systematic review and meta-analysis.
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DOI：
10.1183/09031936.00070812
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发表时间：
2013-01
期刊：
影响因子：
--
通讯作者：
Marks GB
中科院分区：
文献类型：
--
作者：
Fox GJ;Barry SE;Britton WJ;Marks GB
对结核病患者接触者进行调查是高收入国家结核病控制的一项重点工作，在资源有限的环境中也日益受到重视。本次审查是为世界卫生组织专家小组制定全球接触调查指南而委托进行的。我们对所有报告结核病患病率和潜伏性结核病感染以及结核病患者接触者中结核病年发病率的研究进行了系统回顾和荟萃分析。在筛选了9555篇论文后，我们纳入了203篇已发表的研究。在来自低收入和中等收入环境的95项研究中，所有接触者的活动性结核病患病率为3.1% (95% CI 2.2-4.4%, I2=99.4%)，微生物证实的结核病患病率为1.2% (95% CI 0.9-1.8%, I2=95.9%)，潜伏性结核病感染率为51.5% （95% CI 47.1-55.8%, I2=98.9%）。家庭接触者中结核病患病率为3.1% (95% CI 2.1-4.5%, I2=98.8%)，耐多药或广泛耐药结核病患者接触者中结核病患病率为3.4% （95% CI 0.8-12.6%, I2=95.7%）。在接触后的第一年发病率最高。在来自高收入环境的108项研究中，接触者之间的结核病患病率为1.4% (95% CI 1.1-1.8%, I2=98.7%)，潜伏感染患病率为28.1% （95% CI 24.2-32.4%, I2=99.5%）。在已发表的研究中存在很大的异质性。结核病患者的接触者是发生结核病的高危人群，特别是在第一年。5岁以下儿童和艾滋病毒感染者尤其处于危险之中。政策建议必须考虑各种接触者追踪战略的成本效益证据，并纳入加强病例发现的补充战略。
Investigation of contacts of patients with tuberculosis (TB) is a priority for TB control in high-income countries, and is increasingly being considered in resource-limited settings. This review was commissioned for a World Health Organization Expert Panel to develop global contact investigation guidelines. We performed a systematic review and meta-analysis of all studies reporting the prevalence of TB and latent TB infection, and the annual incidence of TB among contacts of patients with TB. After screening 9,555 titles, we included 203 published studies. In 95 studies from low- and middle-income settings, the prevalence of active TB in all contacts was 3.1% (95% CI 2.2–4.4%, I2=99.4%), microbiologically proven TB was 1.2% (95% CI 0.9–1.8%, I2=95.9%), and latent TB infection was 51.5% (95% CI 47.1–55.8%, I2=98.9%). The prevalence of TB among household contacts was 3.1% (95% CI 2.1–4.5%, I2=98.8%) and among contacts of patients with multidrug-resistant or extensively drug-resistant TB was 3.4% (95% CI 0.8–12.6%, I2=95.7%). Incidence was greatest in the first year after exposure. In 108 studies from high-income settings, the prevalence of TB among contacts was 1.4% (95% CI 1.1–1.8%, I2=98.7%), and the prevalence of latent infection was 28.1% (95% CI 24.2–32.4%, I2=99.5%). There was substantial heterogeneity among published studies. Contacts of TB patients are a high-risk group for developing TB, particularly within the first year. Children <5 yrs of age and people living with HIV are particularly at risk. Policy recommendations must consider evidence of the cost-effectiveness of various contact tracing strategies, and also incorporate complementary strategies to enhance case finding.
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影响因子：
3.6
作者：
Almeida, LMD;Barbieri, MA;Cuevas, LE
通讯作者：
Cuevas, LE
DOI：
10.1007/s11524-009-9378-z
发表时间：
2009-09-01
影响因子：
6.6
作者：
Asghar, Rana Jawad;Patlan, David E.;Oeltmann, John E.
通讯作者：
Oeltmann, John E.
DOI：
10.1164/rccm.200711-1756oc
发表时间：
2008-05-01
影响因子：
24.7
作者：
Aissa, Khaoula;Madhi, Fouad;Delacourt, Christophe
通讯作者：
Delacourt, Christophe
影响因子：
--
作者：
Anibarro, Luis;Trigo, Matilde;Gonzalez-Fernandez, Africa
通讯作者：
Gonzalez-Fernandez, Africa
影响因子：
12.7
作者：
Andre, McKenzie;Ijaz, Kashef;McElroy, Peter D.
通讯作者：
McElroy, Peter D.