An evaluation of tuberculosis contact investigations against national standards.
An evaluation of tuberculosis contact investigations against national standards.
复制标题
DOI：
10.1136/thoraxjnl-2016-209677
复制
发表时间：
2017-08
期刊：
影响因子：
10
通讯作者：
Anderson C
中科院分区：
文献类型：
--
作者：
Cavany SM;Sumner T;Vynnycky E;Flach C;White RG;Thomas HL;Maguire H;Anderson C
接触者追踪是英格兰2015年结核病合作战略的一个关键要素，尽管成功追踪接触者的拟议指标尚未描述。我们使用来自伦敦结核病登记处的队列回顾数据，对2012年7月1日至2015年12月31日期间伦敦结核病病例的接触者追踪进行了描述性和多变量分析，确定了与改善指标和产量相关的特征。在通知的肺结核病例中，60%（2716/4561）有足够的信息可供纳入。其中，91%（2481/2716）的患者至少识别出1次接触（中位数：4/例（IQR：2 - 6）），其中86%（10 251/11 981）的患者接受了评价。 肺涂阳、肺涂阴和非肺接触者中分别有4.1%（177/4328）、1.3%（45/3421）和0.70%（51/7264）有活动性疾病。前囚犯或男性的情况下，不太可能有至少一个接触确定比那些从未入狱或女性，分别。在有更直接观察治疗或社会工作者的诊所诊断的病例更有可能有一个或多个接触者。在不同的诊所筛选接触他们的索引病例或男性索引病例不太可能比在同一诊所或妇女，分别筛选进行评价;收益率的活动性疾病是相似的性别。10%（490/4850）的儿童接触者有潜伏性结核感染。这是首次在伦敦范围内对结核病接触者追踪指标进行评估，这些指标对于监测战略的成功和为指数病例的风险评估提供信息至关重要。了解群体之间指标差异的原因可以改善接触者追踪结果。
Contact tracing is a key element in England's 2015 collaborative TB strategy, although proposed indicators of successful contact tracing remain undescribed. We conducted descriptive and multivariable analyses of contact tracing of TB cases in London between 1 July 2012 and 31 December 2015 using cohort review data from London's TB Register, identifying characteristics associated with improved indicators and yield. Of the pulmonary TB cases notified, 60% (2716/4561) had sufficient information for inclusion. Of these, 91% (2481/2716) had at least 1 contact (median: 4/case (IQR: 2–6)) identified, with 86% (10 251/11 981) of these contacts evaluated. 4.1% (177/4328), 1.3% (45/3421) and 0.70% (51/7264) of evaluated contacts of pulmonary smear-positive, pulmonary smear-negative and non-pulmonary cases, respectively, had active disease. Cases who were former prisoners or male were less likely to have at least one contact identified than those never imprisoned or female, respectively. Cases diagnosed at clinics with more directly observed therapy or social workers were more likely to have one or more contacts identified. Contacts screened at a different clinic to their index case or of male index cases were less likely to be evaluated than those screened at the same clinic or of women, respectively; yield of active disease was similar by sex. 10% (490/4850) of evaluated child contacts had latent TB infection. These are the first London-wide estimates of TB contact tracing indicators which are important for monitoring the strategy's success and informing risk assessment of index cases. Understanding why differences in indicators occur between groups could improve contact tracing outcomes.
登录
查看更多内容
影响因子：
13.3
作者：
Mandal, P.;Craxton, R.;Hill, A. T.
通讯作者：
Hill, A. T.
DOI：
10.1183/09031936.00070812
发表时间：
2013-01
期刊：
The European respiratory journal
影响因子：
--
作者：
Fox GJ;Barry SE;Britton WJ;Marks GB
通讯作者：
Marks GB
影响因子：
10
作者：
Anderson, Charlotte;White, Jacqueline;Dart, Susan
通讯作者：
Dart, Susan
DOI：
10.1016/0962-8479(92)90058-r
发表时间：
1992-04-01
期刊：
TUBERCLE AND LUNG DISEASE
影响因子：
--
作者：
VEEN, J
通讯作者：
VEEN, J
影响因子：
5.1
作者：
MacIntyre, CR;Plant, AJ
通讯作者：
Plant, AJ