Risk factors for tuberculosis.
Risk factors for tuberculosis.
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DOI：
10.1155/2013/828939
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发表时间：
2013
影响因子：
4.3
通讯作者：
Mathai D
中科院分区：
文献类型：
--
作者：
Narasimhan P;Wood J;Macintyre CR;Mathai D
从暴露于结核杆菌到发展为活动性疾病的风险是一个由外源性和内源性风险因素控制的两阶段过程。外源性因素在加重从暴露到感染的进展中起关键作用，其中痰中的细菌负荷和个体与传染性结核病例的接近是关键因素。类似地，内源性因素导致从感染进展为活动性TB疾病。沿着已确立的风险因素（如人类免疫缺陷病毒（HIV）、营养不良和年轻），糖尿病、室内空气污染、酒精、免疫抑制药物的使用和吸烟等新出现的变量在个人和人群层面上都发挥着重要作用。社会经济和行为因素也显示出增加感染的易感性。卫生保健工作者和土著居民等特定群体感染结核病的风险也在增加。本文总结了这些因素沿着卫生系统的问题，如结核病诊断延误对结核杆菌传播的影响。
The risk of progression from exposure to the tuberculosis bacilli to the development of active disease is a two-stage process governed by both exogenous and endogenous risk factors. Exogenous factors play a key role in accentuating the progression from exposure to infection among which the bacillary load in the sputum and the proximity of an individual to an infectious TB case are key factors. Similarly endogenous factors lead in progression from infection to active TB disease. Along with well-established risk factors (such as human immunodeficiency virus (HIV), malnutrition, and young age), emerging variables such as diabetes, indoor air pollution, alcohol, use of immunosuppressive drugs, and tobacco smoke play a significant role at both the individual and population level. Socioeconomic and behavioral factors are also shown to increase the susceptibility to infection. Specific groups such as health care workers and indigenous population are also at an increased risk of TB infection and disease. This paper summarizes these factors along with health system issues such as the effects of delay in diagnosis of TB in the transmission of the bacilli.