Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China

Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China
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中国青少年病例家庭和课堂结核病传播情况与社区的比较

DOI:
10.3390/ijerph15122803
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发表时间:
2018-12
影响因子:
--
通讯作者:
Chongsuvivatwong Virasakdi
Chongsuvivatwong Virasakdi
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Pan Dongxiang;Lin Mei;Lan Rushu;Graviss Edward A;Lin Dingwen;Liang Dabin;Long Xi;Qin Huifang;Huang Liwen;Huang Minying;Chongsuvivatwong Virasakdi

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目的探讨家庭结核病接触史与在校确诊肺结核病例的关系,并比较青少年结核病家庭接触者和课堂接触者活动性肺结核的发现率与健康对照接触者活动性肺结核的发现率。从2016年11月至2017年12月,采用被动识别的来自结核病监测系统的青少年学生病例和健康对照(按县、学校类型、性别、年龄和种族匹配)进行前瞻性配对病例对照研究。调查了指示病例和对照病例的家庭和教室接触者。对117对病例对照的配对列表显示,家庭中暴露于结核病是一个强烈的危险因素(优势比(OR)=21.0,95%可信区间(CI):3.4,868.6)。在指示病例和对照人群的6512名和6480名教室接触者中,分别发现45例(病例发现率为0.69%)和2例(病例发现率为0.03%)新的活动性肺结核病例。在教室里有一个指示病例显著增加了同学感染活动性结核病的风险(OR=22.595%CI:5.9%,191.4)。我们的发现表明,以前在家庭中接触结核病可能会导致孩子在学校感染结核病,然后将结核病传播给同学。
The aim of this paper is to evaluate the link between the history of exposure to tuberculosis (TB) in the household and diagnosed TB cases at school, and to compare the detection rate of active TB among household contacts and classroom contacts of adolescent TB cases with the rates among contacts of healthy controls. From November 2016 to December 2017, a prospective matched case-control study was conducted using passively identified index adolescent student cases from the TB surveillance system and healthy controls (matched by county, school type, sex, age and ethnicity). Contacts in households and classrooms of index cases and of controls were investigated. Matched tabulation of 117 case-control pairs revealed exposure to TB in the household as a strong risk factor (odds ratio (OR) = 21.0, 95% confidence interval (CI): 3.4, 868.6). Forty-five (case detection rate 0.69%) and two (case detection rate 0.03%) new active TB cases were detected among 6512 and 6480 classroom contacts of the index cases and controls, respectively. Having an index case in the classroom significantly increased the risk of classmates contracting active TB (OR = 22.5, 95% CI: 5.9, 191.4). Our findings suggested that previous exposure to TB in the household could lead a child to catch TB at school, then spread TB to classmates.
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发表时间: 2017
期刊: PloS one
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