Force of tuberculosis infection among adolescents in a high HIV and TB prevalence community: a cross-sectional observation study
Force of tuberculosis infection among adolescents in a high HIV and TB prevalence community: a cross-sectional observation study
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DOI：
10.1186/1471-2334-11-156
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发表时间：
2011-06-01
影响因子：
3.7
通讯作者：
Wood, Robin
中科院分区：
文献类型：
--
作者：
Middelkoop, Keren;Bekker, Linda-Gail;Wood, Robin
背景资料：为了制定有效的结核病控制干预策略，需要了解结核病和艾滋病高流行环境中结核病的传播动态。然而，很少有数据评估这些环境中青少年结核病感染的发生率。方法：我们对艾滋病毒和结核病高发社区的中学生进行了结核菌素皮肤试验（TST）和艾滋病毒调查。3天后读取对纯化的蛋白衍生物RT 23的TST应答。使用Orasure（R）收集装置和ELISA检测评估HIV感染。艾滋病毒未感染的参与者的结果相结合，从以前的调查中小学生在同一社区，和力量的结核病感染计算年龄。结果：820名中学参与者的年龄范围从13至22岁。159人参加了小学调查。在10 mm的临界值下，未感染艾滋病毒和首次参与者的结核感染患病率为54%（n = 334/620）。HIV感染率为5%（n = 40/816）。HIV感染与TST阳性无显著相关性（p = 0.07）。在综合调查数据集中，结核病患病率为45%（n = 645/1451），与年龄和男性性别的增加有关。感染力随着年龄的增长而增加，在≥ 20岁的青少年中从3%增加到7.3%。我们推测这是由于与传染性结核病病例的社会接触增加。在这种情况下控制结核病流行需要降低感染力。
Background: Understanding of the transmission dynamics of tuberculosis (TB) in high TB and HIV prevalent settings is required in order to develop effective intervention strategies for TB control. However, there are little data assessing incidence of TB infection in adolescents in these settings.Methods: We performed a tuberculin skin test (TST) and HIV survey among secondary school learners in a high HIV and TB prevalence community. TST responses to purified protein derivative RT23 were read after 3 days. HIV-infection was assessed using Orasure (R) collection device and ELISA testing. The results of the HIV-uninfected participants were combined with those from previous surveys among primary school learners in the same community, and force of TB infection was calculated by age.Results: The age of 820 secondary school participants ranged from 13 to 22 years. 159 participants had participated in the primary school surveys. At a 10 mm cut-off, prevalence of TB infection among HIV-uninfected and first time participants, was 54% (n = 334/620). HIV prevalence was 5% (n = 40/816). HIV infection was not significantly associated with TST positivity (p = 0.07). In the combined survey dataset, TB prevalence was 45% (n = 645/1451), and was associated with increasing age and male gender. Force of infection increased with age, from 3% to 7.3% in adolescents >= 20 years of age.Conclusions: We show a high force of infection among adolescents, positively associated with increasing age. We postulate this is due to increased social contact with infectious TB cases. Control of the TB epidemic in this setting will require reducing the force of infection.