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Implementing Tuberculosis Close-contact Investigation in a Tertiary Hospital in Iran

机译:在伊朗一家三级医院实施结核病紧密接触调查

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Background: Close contact investigation is the essential key in tuberculosis (TB) case finding and an effective strategy for TB control program within any society. Methods: In this prospective study, 1186 close family contacts of hospitalized TB patients (index) in a referral TB hospital in Tehran-Iran were passively studied. These people were studied to rollout TB infection and disease. Demographic characteristics, clinical and laboratory data of these individuals were reviewed and summarized for analysis. Results: A total of 886 (74.4%) close-family contacts completed their investigation. The index TB patients of these individuals were sputum smear negative for acid-fast bacilli in 137 cases (11.6%) and the rest were smear positive. A total of 610 (68.8%) close-family contact ruled out for TB infection or disease (Group I). A total of 244 cases (27.5%) had latent TB infection (Group II) and active TB (Group III) was confirmed in 32 cases (3.6%). A significant difference was shown for female gender, signs and symptoms, family size, and positive radiological finding between Group I and Group II. The study of index parameter including positive sputum smear/culture did not reveal any significant difference, but positive cavitary lesion significantly more has seen in active TB group ( P = 0.004). Conclusions: This study emphasizes on sign and symptoms and radiological finding in TB contact investigation, where index parameters including positive smear/culture, does not implicate any priority. Although cavitary lesions in index patient have more accompanied by active TB, close contact study should include all of TB indexes. This investigation should include chest radiography for these individuals.
机译:背景:密切接触调查是发现结核病病例的关键,也是任何社会中结核病控制计划的有效策略。方法:在这项前瞻性研究中,对德黑兰-伊朗转诊结核病医院中住院的结核病患者(索引)的1186个近亲进行了被动研究。研究了这些人以推广结核病感染和疾病。回顾并总结了这些个体的人口统计学特征,临床和实验室数据以进行分析。结果:总共886家(74.4%)亲朋好友完成了调查。这些患者的TB指标患者的痰中抗酸杆菌涂片阴性(137例,占11.6%),其余患者涂片阳性。总共有610人(68.8%)的近亲接触排除了TB感染或疾病(I组)。共有244例(27.5%)潜伏性结核感染(II组),活动性TB(III组)确诊为32例(3.6%)。在第一组和第二组之间,女性性别,体征和症状,家庭规模以及放射学阳性结果显示出显着差异。包括痰涂片/培养阳性在内的指标参数的研究没有发现任何显着差异,但是活动性结核病组中阳性空洞病变明显更多(P = 0.004)。结论:本研究强调结核病接触调查中的体征和症状以及放射学发现,其中包括阳性涂片/培养的指标参数并不意味着任何优先事项。尽管该指标患者的空洞病变伴有活动性结核病,但密切接触研究应包括所有结核病指标。这项检查应包括对这些人进行胸部X光检查。

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