Evaluation of investigations conducted to detect and prevent transmission of tuberculosis
Evaluation of investigations conducted to detect and prevent transmission of tuberculosis
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DOI：
10.1001/jama.287.8.991
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发表时间：
2002-02-27
影响因子：
120.7
通讯作者：
Onorato, IM
中科院分区：
文献类型：
--
作者：
Reichler, MR;Reves, R;Onorato, IM
背景接触者调查是美国卫生部门对所有活动性肺结核（TB）病例的常规调查，以确定继发性活动性肺结核和潜伏性结核感染病例，并根据需要对这些接触者进行治疗。人们对所遵循的实际程序或结果知之甚少。目的评价美国卫生部门开展的接触者调查及其结果。设计、设置和受试者：对1996年美国5个研究地区349例15岁以上培养阳性肺结核患者的所有接触者的卫生部门记录进行回顾。每名结核病患者确定、全面筛查和感染的接触者人数；结核病患者接触者的结核病感染率和发病率；接触调查期间收集数据的类型和完整性。结果349例活动性肺结核患者共检出接触者3824人。在结核病患者中，45名（13%）没有确定接触者。在接触者中，55%完成了筛查，27%进行了首次但未进行接触后结核菌素皮肤试验，12%未进行筛查，6%有既往结核病史或结核菌素皮肤试验阳性。在完成筛查的2095名接触者中，68%的人皮肤试验结果为阴性，24%的人皮肤试验结果初步呈阳性，但没有先前的测试结果，7%的人有记录的皮肤试验转化，1%的人在调查时患有活动性结核病。年龄小于15岁的密切接触者(76%接受筛查，而年龄较大的群体为65%
Context Contact investigations are routinely conducted by health departments throughout the United States for all cases of active pulmonary tuberculosis (TB) to identify secondary cases of active TB and latent TB infection and to initiate therapy as needed in these contacts. Little is known about the actual procedures followed, or the results.Objectives To evaluate contact investigations conducted by US health departments and the outcomes of these investigations.Design, Setting, and Subjects Review of health department records for all contacts of 349 patients with culture-positive pulmonary TB aged 15 years or older reported from 5 study areas in the United States during 1996.Main Outcome Measures Number of contacts identified, fully screened, and infected per TB patient; rates of TB infection and disease among contacts of TB patients; and type and completeness of data collected during contact investigations.Results A total of 3824 contacts were identified for 349 patients with active pulmonary TB. Of the TB patients, 45 (13%) had no contacts identified. Of the contacts, 55% completed screening, 27% had an initial but no postexposure tuberculin skin test, 12% were not screened, and 6% had a history of prior TB or prior positive tuberculin skin test. Of 2095 contacts who completed screening, 68% had negative skin test results, 24% had initial positive results with no prior test result available, 7% had documented skin test conversions, and 1% had active TB at the time of investigation. Close contacts younger than 15 years (76% screened vs 65% for older age groups; P