Number needed to screen for TB in clinical, structural or occupational risk groups.
Number needed to screen for TB in clinical, structural or occupational risk groups.
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DOI：
10.5588/ijtld.21.0749
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发表时间：
2022-06-01
影响因子：
4
通讯作者：
Golub, J. E.
中科院分区：
文献类型：
--
作者：
Naufal, F.;Chaisson, L. H.;Robsky, K. O.;Delgado-Barroso, P.;Alvarez-Manzo, H. S.;Miller, C. R.;Shapiro, A. E.;Golub, J. E.
使用主动病例发现(ACF)筛查活动性结核病可能会降低结核病的发病率、患病率和死亡率；然而，ACF干预措施的效果因人群而异。我们系统地回顾了关于ACF的研究报告，以计算筛查结核病高危人群所需的数量。我们对2010年11月至2020年2月发表的关于成人ACF的研究进行了文献检索。我们确定了通过各种筛查策略检测到的活动性结核病患病率，并计算了使用培养或Xpert®MTB/RIF确诊的结核病的粗略NN，以及按筛查策略、风险组和国家/地区结核病发病率分层的加权平均NN。我们筛选了27,223篇摘要；纳入了90项研究(41项在低/中等结核病发病率环境中，49项在中/高结核病发病率环境中)。高危人群包括住院患者、门诊患者、糖尿病患者(PLWD)、移民、监狱囚犯、无家可归者(PEH)、医护人员和矿工。筛查策略包括基于症状的筛查、胸部X光和Xpert测试。根据危险群体和筛查方法的不同，NNS在发病环境中和发病环境中也有很大差异。敏感性较高的筛查工具(如Xpert、CXR)与较低的NNS估计值相关。ACF策略的NNS在成人风险组之间有很大差异。具体的干预措施应根据当地的流行病学和成本进行调整。
Screening for active TB using active case-finding (ACF) may reduce TB incidence, prevalence, and mortality; however, yield of ACF interventions varies substantially across populations. We systematically reviewed studies reporting on ACF to calculate the number needed to screen (NNS) for groups at high risk for TB. We conducted a literature search for studies reporting ACF for adults published between November 2010 and February 2020. We determined active TB prevalence detected through various screening strategies and calculated crude NNS for - TB confirmed using culture or Xpert® MTB/RIF, and weighted mean NNS stratified by screening strategy, risk group, and country-level TB incidence. We screened 27,223 abstracts; 90 studies were included (41 in low/moderate and 49 in medium/high TB incidence settings). High-risk groups included inpatients, outpatients, people living with diabetes (PLWD), migrants, prison inmates, persons experiencing homelessness (PEH), healthcare workers, and miners. Screening strategies included symptom-based screening, chest X-ray and Xpert testing. NNS varied widely across and within incidence settings based on risk groups and screening methods. Screening tools with higher sensitivity (e.g., Xpert, CXR) were associated with lower NNS estimates. NNS for ACF strategies varies substantially between adult risk groups. Specific interventions should be tailored based on local epidemiology and costs.
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DOI：
10.1016/s2468-2667(21)00033-5
发表时间：
2021-05
期刊：
The Lancet. Public health
影响因子：
--
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
通讯作者：
MacPherson P
影响因子：
2.8
作者：
Basir, Mashal S.;Habib, Shifa S.;Khan, Aamir J.
通讯作者：
Khan, Aamir J.
影响因子：
3.8
作者：
Churchyard, Gavin J.;Fielding, Katherine L.;Grant, Alison D.
通讯作者：
Grant, Alison D.
影响因子：
3.7
作者：
Alsdurf H;Empringham B;Miller C;Zwerling A
通讯作者：
Zwerling A
影响因子：
3.7
作者：
Bhatnagar, Tarun;Ralte, Malsawmtluangi;Chhakchhuak, Lily
通讯作者：
Chhakchhuak, Lily