循序渐进:系统性开展结核分枝杆菌潜伏感染流行病学调查

doi:10.19982/j.issn.1000-6621.20230391

摘要/Abstract

摘要：

我国是结核病高负担国家,同时结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)人数众多。高质量地开展LTBI流行病学调查,对于准确掌握我国LTBI的流行特征、评估不同人群的发病风险、开展高危人群的预防性治疗和探索适宜我国国情的结核病预防策略具有重要的指导意义。在本文中,笔者针对开展LTBI流行病学调查的必要性和LTBI流行病学调查的主要技术环节进行了总结和介绍,希望能够为我国系统性开展LTBI流行病学调查工作提供参考。

关键词: 分枝杆菌,结核, 感染, 流行病学研究设计, 健康调查

Abstract:

China has a high burden of tuberculosis and huge population with latent tuberculosis infection (LTBI). Carrying out high-quality epidemiological investigation of LTBI is of great guiding significance for accurately understanding the epidemic characteristics of LTBI in China, assessing the incidence risks of different populations, conducting preventive treatment for high-risk populations, and exploring tuberculosis prevention strategies suitable for China’s national conditions. In this article, the author summarizes and introduces the necessity of carrying out epidemiological investigation of LTBI and the main technical aspects of epidemiological investigation of LTBI, hoping to provide reference for the systematic epidemiological investigation of LTBI in China.

Key words: Mycobacterium tuberculosis, Infection, Epidemiologic research design, Health surveys

中图分类号:

R52
R181

何翼君, 成君, 高磊. 循序渐进:系统性开展结核分枝杆菌潜伏感染流行病学调查[J]. 中国防痨杂志, 2024, 46(1): 1-7. doi: 10.19982/j.issn.1000-6621.20230391

He Yijun, Cheng Jun, Gao Lei. Epidemiological investigation of latent tuberculosis infection should be carried out systematically[J]. Chinese Journal of Antituberculosis, 2024, 46(1): 1-7. doi: 10.19982/j.issn.1000-6621.20230391

参考文献 43

[1]	Houben RM, Dodd PJ. The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling. PLoS Med, 2016, 13(10): e1002152. doi:10.1371/journal.pmed.1002152.
[2]	World Health Organization. WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment. Geneva: World Health Organization, 2020.
[3]	Getahun H, Matteelli A, Chaisson RE, et al. Latent Mycobacterium tuberculosis infection. N Engl J Med, 2015, 372(22): 2127-2135. doi:10.1056/NEJMra1405427.
[4]	World Health Organization. Guidelines on the management of latent tuberculosis infection. Geneva: World Health Organization, 2015.
[5]	World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2018.
[6]	World Health Organization.Global tuberculosis report 2023. Geneva: World Health Organization, 2023.
[7]	中华人民共和国国家卫生健康委员会办公厅. 中国结核病预防控制工作技术规范(2020年版). 国卫办疾控函〔2020〕279号. 2020-04-02.
[8]	王黎霞, 成诗明, 陈伟. 学校结核病防治工作手册. 北京: 军事医学科学出版社, 2012.
[9]	中华人民共和国国家卫生健康委员会办公厅, 中华人民共和国教育部办公厅. 中国学校结核病防控指南(2020年版).国卫办疾控函〔2020〕910号. 2020-10-16.
[10]	成君, 赵雁林. 创建无结核社区终止结核病流行. 中国防痨杂志, 2021, 43(11): 1120-1124. doi:10.3969/j.issn.1000-6621.2021.11.004.
[11]	全国结核病流行病学抽样调查技术指导组,全国结核病流行病学抽样调查办公室. 2000年全国结核病流行病学抽样调查报告. 中国防痨杂志, 2002, 24(2): 65-66. doi:10.3969/j.issn.1000-6621.2002.02.001.
[12]	Gao L, Lu W, Bai L, et al. Latent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study. Lancet Infect Dis, 2015, 15(3): 310-319. doi:10.1016/S1473-3099(14)71085-0. pmid: 25681063
[13]	高磊, 张慧, 胡茂桂, 等. 基于多中心调查数据和空间统计模型的全国结核分枝杆菌潜伏感染率估算. 中国防痨杂志, 2022, 44(1): 54-59. doi:10.19982/j.issn.1000-6621.20210661.
[14]	Xin H, Zhang H, Liu J, et al. Mycobacterium tuberculosis infection among the elderly in 20 486 rural residents aged 50-70 years in Zhongmu County, China. Clin Microbiol Infect, 2019, 25(9): 1120-1126. doi:10.1016/j.cmi.2019.01.021.
[15]	Lu P, Wu K, Zhou H, et al. Evaluation of ESAT6-CFP 10 Skin Test for Mycobacterium tuberculosis Infection among Persons Living with HIV in China. J Clin Microbiol, 2023, 61(4): e0181622. doi:10.1128/jcm.01816-22.
[16]	Xu Y, Yang Q, Zhou J, et al. Comparison of QuantiFERON-TB Gold In-Tube and QuantiFERON-TB Gold-Plus in the Diagnosis of Mycobacterium tuberculosis Infections in Immunocompromised Patients: a Real-World Study. Microbiol Spectr, 2022, 10(2): e0187021. doi:10.1128/spectrum.01870-21.
[17]	He Y, Cao X, Guo T, et al. Serial testing of latent tuberculosis infection in patients with diabetes mellitus using interferon-gamma release assay, tuberculin skin test, and creation tuberculin skin test. Front Public Health, 2022, 10: 1025550. doi:10.3389/fpubh.2022.1025550.
[18]	Chen B, Gu H, Wang X, et al. Prevalence and determinants of latent tuberculosis infection among frontline tuberculosis healthcare workers in southeastern China: A multilevel analysis by individuals and health facilities. Int J Infect Dis, 2019, 79: 26-33. doi:10.1016/j.ijid.2018.11.010. pmid: 30471404
[19]	Xiao X, Chen J, Jiang Y, et al. Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study. Front Cell Infect Microbiol, 2022, 12: 1000663. doi:10.3389/fcimb.2022.1000663.
[20]	中国防痨协会. 高危人群结核分枝杆菌潜伏感染检测及预防性治疗专家共识. 中国防痨杂志, 2021, 43(9): 874-878. doi:10.3969/j.issn.1000-6621.2021.09.004.
[21]	Du Y, He Y, Zhang H, et al. Declining incidence rate of tuberculosis among close contacts in five years post-exposure: a systematic review and meta-analysis. BMC Infect Dis, 2023, 23(1): 373. doi:10.1186/s12879-023-08348-z. pmid: 37270474
[22]	辛赫男, 高磊. 暴露后干预共性技术与结核病预防. 中华疾病控制杂志, 2022, 26(11): 1271-1274. doi:10.16462/j.cnki.zhjbkz.2022.11.006.
[23]	World Health Organization. WHO consolidated guidelines on tuberculosis. Module 3: diagnosis. Tests for tuberculosis infection. Geneva: World Health Organization, 2022.
[24]	王大宽, 何翼君, 刘自森, 等. 一起校园肺结核疫情的流行病学调查分析. 中国防痨杂志, 2021, 43(11): 1194-1198. doi:10.3969/j.issn.1000-6621.2021.11.015.
[25]	Gao L, Li X, Liu J, et al. Incidence of active tuberculosis in individuals with latent tuberculosis infection in rural China: follow-up results of a population-based, multicentre, prospective cohort study. Lancet Infect Dis, 2017, 17(10): 1053-1061. doi:10.1016/S1473-3099(17)30402-4. pmid: 28716677
[26]	World Health Organization. WHO consolidated guidelines on tuberculosis. Module 2: screening-systematic screening for tuberculosis disease. Geneva: World Health Organization, 2021.
[27]	Huynh GH, Klein DJ, Chin DP, et al. Tuberculosis control strategies to reach the 2035 global targets in China: the role of changing demographics and reactivation disease. BMC Med, 2015, 13: 88. doi:10.1186/s12916-015-0341-4. pmid: 25896465
[28]	Wen Z, Li T, Zhu W, et al. Effect of different interventions for latent tuberculosis infections in China: a model-based study. BMC Infect Dis, 2022, 22(1): 488. doi:10.1186/s12879-022-07465-5. pmid: 35606696
[29]	O’Garra A, Redford PS, McNab FW, et al. The immune response in tuberculosis. Annu Rev Immunol, 2013, 31: 475-527. doi:10.1146/annurev-immunol-032712-095939. pmid: 23516984
[30]	Gao L, Bai L, Liu J, et al. Annual risk of tuberculosis infection in rural China: a population-based prospective study. Eur Respir J, 2016, 48(1): 168-178. doi:10.1183/13993003.00235-2016. pmid: 27230438
[31]	何翼君, 张浩然, 辛赫男, 等. 结核菌素皮肤试验的应用及其优化. 中国防痨杂志, 2021, 43(3): 204-210. doi:10.3969/j.issn.1000-6621.2021.03.003.
[32]	Shah M, Dorman SE. Latent Tuberculosis Infection. N Engl J Med, 2021, 385(24): 2271-2280. doi:10.1056/NEJMcp2108501.
[33]	中华医学会结核病学分会. 结核分枝杆菌γ-干扰素释放试验及临床应用专家意见(2021年版). 中华结核和呼吸杂志, 2022, 45(2): 143-150. doi:10.3760/cma.j.cn112147-20211110-00794.
[34]	何翼君, 曹雪芳, 高磊. 《结核菌素皮肤试验-γ干扰素释放试验两步法的操作技术规范》解读. 中国防痨杂志, 2022, 44(5): 438-441. doi:10.19982/j.issn.1000-6621.20210731.
[35]	Song S, Jeon D, Kim JW, et al. Performance of confirmatory interferon-γ release assays in school TB outbreaks. Chest, 2012, 141(4): 983-988. doi:10.1378/chest.11-1158. pmid: 21980060
[36]	高磊, 权竹声, 成君, 等. 结核分枝杆菌感染检测两步法在学校结核病控制工作中的应用探讨. 中华预防医学杂志, 2020, 54(4): 385-391. doi:10.3760/cma.j.cn112150-20191204-00909.
[37]	郭同磊, 辛赫男, 高磊. 《世界卫生组织结核病整合指南模块1:结核病预防性治疗》解读. 中国防痨杂志, 2023, 45(8): 723-727. doi:10.19982/j.issn.1000-6621.20230199.
[38]	上海市防痨协会, 中国防痨协会青年理事会,《中国防痨杂志》编辑委员会. 学校结核病疫情流行病学调查和现场处置专家共识. 中国防痨杂志, 2019, 41(1): 9-13. doi:10.3969/j.issn.1000-6621.2019.01.004.
[39]	中华人民共和国国家卫生和计划生育委员会. WS 288—2017肺结核诊断. 2017-11-09.
[40]	Xin H, Du Y, Cao X, et al. Algorithms for Screening for Active Tuberculosis among Individuals with Latent Tuberculosis Infection in a Rural Community in China. Microbiol Spectr, 2022, 10(6): e0296722. doi:10.1128/spectrum.02967-22.
[41]	李静, 任菁菁, 刘颖, 等. 流行病学调查研究中的质量控制. 实用预防医学, 2016, 23(5): 634-638. doi:10.3969/j.issn.1006-3110.2016.05.041.
[42]	Cui X, Gao L, Cao B. Management of latent tuberculosis infection in China: Exploring solutions suitable for high-burden countries. Int J Infect Dis, 2020, 92s: S37-S40. doi:10.1016/j.ijid.2020.02.034. pmid: 32114201
[43]	徐彩红, 赵雁林. 中国结核病预防性治疗指南. 北京: 人民卫生出版社, 2023.