Tuberculosis in household contacts of infectious cases in Kampala, Uganda
Tuberculosis in household contacts of infectious cases in Kampala, Uganda
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DOI：
10.1093/aje/kwg227
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发表时间：
2003-11-01
影响因子：
5
通讯作者：
Whalen, CC
中科院分区：
文献类型：
--
作者：
Guwatudde, D;Nakakeeto, M;Whalen, CC
结核病仍然是对公共卫生的严重威胁，特别是在撒哈拉以南非洲。为了确定导致非洲家庭结核病的宿主和环境因素，作者对1995年至1999年在乌干达登记的302例结核病指标病例的1,206名家庭接触者进行了前瞻性队列研究。对所有接触者进行了活动性结核病和活动性疾病风险因素的系统评估。在1，206名家庭接触者中，发现了76例继发性肺结核病例（6%）。在这些病例中，51例在基线评价中确定，25例在随访期间发生。与索引病例相比，继发性病例更常表现为轻微病变。继发性结核病的风险在幼儿中高于成人（10%比1.9%），在人类免疫缺陷病毒血清阳性接触者中高于血清阴性接触者（23%比3.3%）。宿主风险因素不能与环境风险因素的影响完全分开，这表明一个家庭可能是一个复杂的系统，相互作用的结核病风险。
Tuberculosis remains a serious threat to public health, especially in sub-Saharan Africa. To determine the host and environmental factors responsible for tuberculosis in African households, the authors performed a prospective cohort study of 1,206 household contacts of 302 index cases with tuberculosis enrolled in Uganda between 1995 and 1999. All contacts were systematically evaluated for active tuberculosis and risk factors for active disease. Among the 1,206 household contacts, 76 secondary cases (6%) of tuberculosis were identified. Of these cases, 51 were identified in the baseline evaluation, and 25 developed during follow-up. Compared with index cases, secondary cases presented more often with minimal disease. The risk for secondary tuberculosis was greater among young children than adults (10% vs. 1.9%) and among human immunodeficiency virus-seropositive than -seronegative contacts (23% vs. 3.3%). Host risk factors could not be completely separated from the effects of environmental risk factors, suggesting that a household may represent a complex system of interacting risks for tuberculosis.