实事求是抓住核心 脚踏实地精准防控

doi:10.3969/j.issn.1000-6621.2019.10.002

中国防痨杂志 ›› 2019, Vol. 41 ›› Issue (10): 1074-1079.doi: 10.3969/j.issn.1000-6621.2019.10.002

实事求是抓住核心脚踏实地精准防控

高谦(),梅建,谭卫国

深圳市慢性病防治中心肺部疾病防治研究所 (谭卫国)

收稿日期:2019-08-26 出版日期:2019-10-10 发布日期:2019-10-09
通信作者: 高谦 E-mail:qiangao@fudan.edu.cn
基金资助:
"十三五"国家科技重大专项(2017ZX10201302-006);深圳市医疗卫生三名工程项目(SZSM201611030)

Tuberculosis control strategy based on the discovery of infectious sources

Qian GAO(),Jian MEI,Wei-guo TAN

^*Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS),School of Basic Medical Sciences, Shanghai Medical College, Fudan University,Shanghai 200032, China

Received:2019-08-26 Online:2019-10-10 Published:2019-10-09
Contact: Qian GAO E-mail:qiangao@fudan.edu.cn

摘要/Abstract

摘要：

随着WHO提出2035年消灭结核病的伟大目标,对结核潜伏感染者进行预防性干预作为重要的创新策略受到了国内外的重视。中国是全球结核病第二高负担国家,结核病防控形势十分严峻。在这种情形下更需要对我国结核病疫情保持清醒的认识,抓住结核病控制的核心和重点。作者从结核潜伏感染的定义、潜伏感染人群发病的时间,以及国外结核病控制的成功经验等方面,进一步说明在结核病高负担国家,近期传播是导致结核病高疫情的主要原因,发现传染源仍然是目前结核病控制的核心;同时,提出重视留取痰液质量和建立区域性实验室是提高我国病原学检测能力、发现传染源、控制结核病传播的重要手段。

关键词: 结核, 潜伏性结核病, 传染性疾病传播, 垂直, 传染病控制, 评论

Abstract:

With WHO’s grand goal of eliminating tuberculosis by 2035, preventive interventions for latent infections of TB have received significant attention as innovation strategies. China is the second-highest TB burden country in the world. It is even more necessary to understand the tuberculosis epidemic in China and to grasp the critical points of tuberculosis control. We reviewed the definition of latent infection, the incubation period of latent infection, and the successful experience of tuberculosis control in abroad. We emphasize that the new transmission is the leading cause for high TB burden countries, and discovery the source of infection is still the key for the TB control program. At the same time, it is an essential means to improve the quality of sputum and establish regional laboratories to enhance the ability of detection of TB in China, and to control the transmission of TB.

Key words: Tuberculosis, Latent tuberculosis, Infectious disease transmission, vertical, Communicable disease control, Comment

高谦,梅建,谭卫国. 实事求是抓住核心脚踏实地精准防控[J]. 中国防痨杂志, 2019, 41(10): 1074-1079. doi: 10.3969/j.issn.1000-6621.2019.10.002

Qian GAO,Jian MEI,Wei-guo TAN. Tuberculosis control strategy based on the discovery of infectious sources[J]. Chinese Journal of Antituberculosis, 2019, 41(10): 1074-1079. doi: 10.3969/j.issn.1000-6621.2019.10.002

参考文献 18

[1]	World Health Organization. Latent tuberculosis infection:Updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2018.
[2]	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.
[3]	World Health Organization. Global tuberculosis report 2018. Geneva: World Health Organization, 2018.
[4]	Barry CE 3rd, Boshoff HI, Dartois V , et al. The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nat Rev Microbiol, 2009,7(12):845-855.
[5]	Houben RM, Dodd PJ . The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling. PLoS Med, 2016,13(10):e1002152.
[6]	Behr MA, Edelstein PH, Ramakrishnan L . Revisiting the time-table of tuberculosis. BMJ, 2018,362:k2738.
[7]	Sloot R, Schim van der Loeff MF, Kouw PM , et al. Risk of tuberculosis after recent exposure. A 10-year follow-up study of contacts in Amsterdam. Am J Respir Crit Care Med, 2014,190(9):1044-1052.
[8]	Borgdorff MW, Sebek M, Geskus RB , et al. The incubation period distribution of tuberculosis estimated with a molecular epidemiological approach. Int J Epidemiol, 2011,40(4):964-970.
[9]	Canetti G, Sutherland I, Svandova E . Endogenous reactivation and exogenous reinfection: their relative importance with regard to the development of non-primary tuberculosis. Bull Int Union Tuberc, 1972,47:116-134.
[10]	Yang C, Luo T, Shen X , et al. Transmission of multidrug-resistant Mycobacterium tuberculosis in Shanghai, China: a retrospective observational study using whole-genome sequencing and epidemiological investigation. Lancet Infect Dis, 2017,17(3):275-284.
[11]	McCarthy OR . Asian immigrant tuberculosis—the effect of visiting Asia. Br J Dis Chest, 1984,78(3):248-253.
[12]	Ferebee SH . Controlled chemoprophylaxis trials in tuberculosis. A general review. Bibl Tuberc, 1970,26:28-106.
[13]	高谦, 杨崇广 . 我国结核病近期传播与控制策略. 结核病与肺部健康杂志, 2017,6(3):193-198.
[14]	高谦, 梅建 . 传播才是造成我国结核病高耐药率的主要原因. 中国防痨杂志, 2015,37(11):1091-1096.
[15]	Yang C, Gao Q . Recent transmission of Mycobacterium tuberculosis in China: the implication of molecular epidemiology for tuberculosis control. Front Med, 2018,12(1):76-83.
[16]	LoBue PA, Mermin JH . Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA. Lancet Infect Dis, 2017,17(10):e327-333.
[17]	Jiang Q, Ji L, Qiu Y , et al. A randomised controlled trial of stepwise sputum collection to increase yields of confirmed tuberculosis. Int J Tuberc Lung Dis, 2019,23(6):685-691.
[18]	Gonzalez-Angulo Y, Wiysonge CS, Geldenhuys H , et al. Sputum induction for the diagnosis of pulmonary tuberculosis: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis, 2012,31(7):1619-1630.

实事求是抓住核心脚踏实地精准防控

Tuberculosis control strategy based on the discovery of infectious sources

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实事求是抓住核心 脚踏实地精准防控

Tuberculosis control strategy based on the discovery of infectious sources

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实事求是抓住核心脚踏实地精准防控