Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania
Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania
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DOI：
10.5588/ijtld.13.0208
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发表时间：
2014-07-01
影响因子：
4
通讯作者：
Bruce, R. D.
中科院分区：
文献类型：
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作者：
Gupta, A.;Mbwambo, J.;Bruce, R. D.
背景：主动发现病例是世界卫生组织 (WHO) 认可的一项改善结核病 (TB) 病例发现的策略。尽管世界卫生组织建议在注射吸毒者（PWID）中积极发现病例，但发表的研究很少。历史上病例发现的重点是人类免疫缺陷病毒呈阳性、被监禁或职业风险较高的人群。 目的：我们试图调查坦桑尼亚新开始使用美沙酮的吸毒者中主动病例发现的情况。设计：在 222 名美沙酮使用者中，156 名（70%）与研究管理员会面； 150 人同意参加，其中 139 人（93%）为男性。中位年龄为 34 岁。研究人员制定了基于症状的调查问卷，并由斯瓦希里语母语人士对每位同意的患者进行了调查。结果：在接受调查的 150 名患者中，16 名 (11%) 患有一种或多种结核病症状，并被转介进行实验室检测。在这项积极的病例发现计划中，发现了 6 例新的结核病病例，患病率为 4%。 结论：这项研究首次提供了坦桑尼亚吸毒者群体中结核病患病率的数据。这一患病率是坦桑尼亚结核病总体患病率 0.2% 的 23 倍。这些结果对结核病控制具有重要意义。
SETTING: Active case finding is a World Health Organization (WHO) endorsed strategy for improving tuberculosis (TB) case detection. Despite WHO recommendations for active case finding among people who inject drugs (PWID), few studies have been published. The historical focus of case finding has been in populations that are human immunodeficiency virus-positive, incarcerated or at higher occupational risk.OBJECTIVE: We sought to examine the yield of active case finding among PWID newly started on methadone in Tanzania.DESIGN: Of 222 methadone clients, 156 (70%) met with study administrators; 150 consented to participate, 139 (93%) of whom were male. The median age was 34 years. A symptom-based questionnaire was developed by the investigators and administered to every consenting patient by a native Swahili speaker.RESULTS: Of the 150 patients surveyed, 16(11%) had one or more TB symptoms and were referred for laboratory testing. Six new TB cases were identified in this active case finding program, with a prevalence of 4%.CONCLUSION: This study presents the first data on TB prevalence in a population of PWID in Tanzania. This prevalence is 23 times that of the general Tanzanian TB prevalence of 0.2%. These results have significant implications for TB control.