Subclinical Tuberculosis Disease-A Review and Analysis of Prevalence Surveys to Inform Definitions, Burden, Associations, and Screening Methodology.
Subclinical Tuberculosis Disease-A Review and Analysis of Prevalence Surveys to Inform Definitions, Burden, Associations, and Screening Methodology.
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DOI：
10.1093/cid/ciaa1402
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发表时间：
2021-08-02
期刊：
影响因子：
--
通讯作者：
Houben RMGJ
中科院分区：
文献类型：
--
作者：
Frascella B;Richards AS;Sossen B;Emery JC;Odone A;Law I;Onozaki I;Esmail H;Houben RMGJ
虽然已知相当大比例的结核病（TB）患者存在亚临床表现，通常定义为细菌学确诊但症状筛查阴性，但仍存在相当大的知识差距。我们的目的是审查结核病流行人口调查的数据，并为亚临床结核病制定一致的定义和框架，使我们能够估计亚临床结核病的比例，探索与总体负担和项目指标的相关性，并评估筛查策略的性能。我们从1990年以来进行的所有公开的流行率调查中提取数据。36.1%至79.7%（中位数为50.4%）的流行细菌学确诊结核病为亚临床结核病。未发现亚临床和所有细菌学确诊的结核病患病率、患者诊断率或国家级HIV患病率之间存在关联（P值分别为0.32、0.4和0.34）。胸部X光检测出89%（范围73%-98%）的细菌学确诊结核病，突出了优化当前结核病病例发现政策的潜力。我们对结核病患病率调查的分析显示，50.4%的细菌学确诊的结核病患者为亚临床型，即症状筛查阴性。胸部X线检出率为89%。这可能意味着肺结核病例发现政策的改变。
While it is known that a substantial proportion of individuals with tuberculosis disease (TB) present subclinically, usually defined as bacteriologically-confirmed but negative on symptom screening, considerable knowledge gaps remain. Our aim was to review data from TB prevalence population surveys and generate a consistent definition and framework for subclinical TB, enabling us to estimate the proportion of TB that is subclinical, explore associations with overall burden and program indicators, and evaluate the performance of screening strategies. We extracted data from all publicly available prevalence surveys conducted since 1990. Between 36.1% and 79.7% (median, 50.4%) of prevalent bacteriologically confirmed TB was subclinical. No association was found between prevalence of subclinical and all bacteriologically confirmed TB, patient diagnostic rate, or country-level HIV prevalence (P values, .32, .4, and .34, respectively). Chest Xray detected 89% (range, 73%–98%) of bacteriologically confirmed TB, highlighting the potential of optimizing current TB case-finding policies. Our analysis of tuberculosis prevalence surveys showed that a median of 50.4% of prevalent bacteriologically confirmed tuberculosis was subclinical, meaning negative on symptom screening. Chest X ray detected 89% of cases. This could potentially suggest a change in tuberculosis case-finding policies.
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发表时间：
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期刊：
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影响因子：
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