Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities: Implications for Tuberculosis Control in the Era of HIV
Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities: Implications for Tuberculosis Control in the Era of HIV
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DOI：
10.1371/journal.pone.0005602
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发表时间：
2009-05-19
期刊：
影响因子：
3.7
通讯作者：
Godfrey-Faussett, Peter
中科院分区：
文献类型：
--
作者：
Ayles, Helen;Schaap, Albertus;Godfrey-Faussett, Peter
背景：遏制结核病伙伴关系的结核病目标是在2015年至1990年期间将结核病患病率降低50%。这一目标具有挑战性，因为很少进行流行率调查，特别是在结核病和艾滋病毒高负担国家。因此，目前结核病控制策略在艾滋病毒高流行的设置是基于有限的流行病学证据和更多的证据是需要从以社区为基础的调查，以提高政策formation.Methods和调查结果：8044成年人抽样2个分区（病房）在卢萨卡省，赞比亚。使用试纸筛查症状，采集呼吸道样本进行培养，并收集口腔分泌物进行艾滋病毒检测。79人的痰中发现结核分枝杆菌，调整后的结核病总患病率为870/100，000（95% CI 570-1160/100，000）。调整后的HIV总患病率为28.61%（95%CI 26.04-31.19）。HIV感染与结核病流行显著相关（Adj OR 2.3，95%CI 1.42-3.74），HIV对结核病流行的人群归因率为36%。症状如长时间咳嗽（调整OR 12.72，95% CI 7.05-22.94）和发热（调整OR 2.04，95%CI 1.23-3.39），与结核病流行相关，但有8名（10%）结核病患者否认有任何症状，只有34名（43%）结论：未确诊的结核病是结核病控制的一个挑战，如果我们要达到国际目标，需要新的方法。流行病学研究可以为检测和预防活动性结核病的筛查算法提供信息。
Background: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation.Methods and Findings: 8044 adults were sampled from 2 sub-districts (wards) in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000). The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19). HIV-infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74) and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94) and fever (Adj OR 2.04, 95% CI 1.23-3.39), were associated with prevalent tuberculosis, but 8 (10%) individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43%) would have been classified as a TB suspect by current guidelines.Conclusions: Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis.