Well-quantified tuberculosis exposure is a reliable surrogate measure of tuberculosis infection
Well-quantified tuberculosis exposure is a reliable surrogate measure of tuberculosis infection
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DOI：
10.5588/ijtld.12.0027
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发表时间：
2012-08-01
影响因子：
4
通讯作者：
Hesseling, A. C.
中科院分区：
文献类型：
--
作者：
Mandalakas, A. M.;Kirchner, H. L.;Hesseling, A. C.
环境：开普敦，南非。目的：制定一个标准化的，可靠的措施，家庭结核病（TB）暴露，考虑儿童特有的风险factors.DESIGN：我们评估了结核病暴露在536名儿童。如果三项感染测试中有两项呈阳性，则儿童被认为是结核分枝杆菌感染。主成分分析确定了一组离散的成分，这些成分共同描述了接触情况，并对复合接触评分做出了贡献。Logistic回归评估了M.结果：四个因素描述了68%的数据方差：1）母亲结核病和睡眠接近度，2）指示病例传染性，3）暴露持续时间，4）暴露于多个指示病例。组成部分来自10个二元问题，这些问题对接触评分有贡献（范围1-10，中位数5，第25 - 75四分位数间距[IQR] 4-7）。在3个月至6岁的儿童与家庭接触，是M的几率。结核病感染者的接触得分每增加1分，结核病感染者的接触得分增加74%（OR 1.74，95%CI 1.42-2.12）。在高负担环境中，儿童家庭接触者的结核病感染，并可以指导有针对性的预防性治疗的儿童在最高风险的M。肺结核感染。
SETTING : Cape Town, South Africa.OBJECTIVE: To develop a standardized, reliable measure of household tuberculosis (TB) exposure that considers child-specific risk factors.DESIGN: We assessed TB exposure in 536 children. Children were considered Mycobacterium tuberculosis infected if two of three tests of infection were positive. Principal component analysis identified a discrete set of components that collectively described exposure and contributed to a composite contact score. Logistic regression assessed the odds of having M. tuberculosis infection given increasing contact score while controlling for age and past TB treatment.RESULTS: Four components described 68% of data variance: 1) maternal TB and sleep proximity, 2) index case infectivity, 3) duration of exposure, and 4) exposure to multiple index cases. Components were derived from 10 binary questions that contributed to a contact score (range 1-10, median 5, 25th-75th interquartile range [IQR] 4-7). Among children aged 3 months to 6 years with household exposure, the odds of being M. tuberculosis-infected increased by 74% (OR 1.74, 95%CI 1.42-2.12) with each 1-point increase in the contact score.CONCLUSIONS: Well-quantified TB exposure is a good surrogate measure of M. tuberculosis infection in child household contacts in a high-burden setting, and could guide targeted preventive treatment in children at highest risk of M. tuberculosis infection.