终止结核病流行须加强结核分枝杆菌潜伏感染高危人群筛查和预防性治疗的管理

doi:10.19982/j.issn.1000-6621.20220008

中国防痨杂志 ›› 2022, Vol. 44 ›› Issue (3): 209-214.doi: 10.19982/j.issn.1000-6621.20220008

终止结核病流行须加强结核分枝杆菌潜伏感染高危人群筛查和预防性治疗的管理

马艳¹, 陆伟², 高磊³, 初乃惠⁴, 周林⁵, 成诗明⁶()

¹中国中医科学院中医临床基础医学基础所,北京 100700
²江苏省疾病预防控制中心,南京 210009
³中国医学科学院病原生物学研究所,北京 100730
⁴北京市结核病胸部肿瘤研究所/首都医科大学附属北京胸科医院结核一科,北京 101149
⁵中国疾病预防控制中心结核病预防控制中心患者关怀部,北京 102206
⁶中国防痨协会,北京 100710

收稿日期:2022-01-20 出版日期:2022-03-10 发布日期:2022-03-08
通信作者: 成诗明 E-mail:smcheng@163.com
基金资助:
“十二五”国家科技重大专项(2014ZX10003002-004);“十二五”国家科技重大专项(2015ZX09108-003);“十三五”国家科技重大专项(2018ZX10731301);“十三五”国家科技重大专项(2020ZX09201001-005);“十三五”国家科技重大专项(2018ZX10103001-001-008);“十三五”国家科技重大专项(2017ZX10201301-001-003);“十三五”国家科技重大专项(2017ZX09304009)

To end tuberculosis epidemic needs strengthen the management of screening and preventive treatment of latent tuberculosis infection in high-risk groups

MA Yan¹, LU Wei², GAO Lei³, CHU Nai-hui⁴, ZHOU Lin⁵, CHENG Shi-ming⁶()

¹Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
²Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
³Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730,China
⁴Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149, China
⁵Department of Patient Care, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
⁶Chinese Antituberculosis Association, Beijing 100710, China

Received:2022-01-20 Online:2022-03-10 Published:2022-03-08
Contact: CHENG Shi-ming E-mail:smcheng@163.com
Supported by:
Major National Science and Technology Projects in the 12th Five Year Plan(2014ZX10003002-004);Major National Science and Technology Projects in the 12th Five Year Plan(2015ZX09108-003);Major National Science and Technology Projects in the 13th Five Year Plan(2018ZX10731301);Major National Science and Technology Projects in the 13th Five Year Plan(2020ZX09201001-005);Major National Science and Technology Projects in the 13th Five Year Plan(2018ZX10103001-001-008);Major National Science and Technology Projects in the 13th Five Year Plan(2017ZX10201301-001-003);Major National Science and Technology Projects in the 13th Five Year Plan(2017ZX09304009)

摘要/Abstract

摘要：

当前,全球结核病发病率下降缓慢,给实现终止结核病目标带来了严峻的挑战。2020年估算全球结核分枝杆菌潜伏感染人群近20亿,在无预防性治疗干预情况下,其中有5%~10%的感染者在一生中会发展为活动性结核病,在结核病高危人群中发病率更高。世界卫生组织在全球范围内号召推广结核分枝杆菌潜伏感染(LTBI)的预防干预,以实现结核病发病率快速下降的目标。笔者就LTBI流行和预防性治疗的现状、高危人群发病风险、筛查方法、干预和管理建议等进行论述,为制定我国LTBI干预和管理策略及措施提供参考。

关键词: 分枝杆菌,结核, 传染病潜伏期, 诊断, 预防和防护用药

Abstract:

Currently, the slow decline of tuberculosis incidence rate becomes a huge challenge to the goal of ending tuberculosis. In 2020, the estimated global latent tuberculosis infection (LTBI) population was nearly 2 billion. With the condition of no preventive intervention, 5% to 10% of them will develop into active tuberculosis in the lifetime, and the incidence rate is higher in high-risk population. The World Health Organization has called for the promotion of the prevention of LTBI worldwide, so as to achieve the goal of a rapid decline in the incidence rate of tuberculosis. This paper reviews the current situation of LTBI epidemic and preventive treatment, the incidence risk of high-risk population, screening methods, intervention and management suggestions, etc., in order to provide reference for formulating LTBI intervention and management strategies and measures in China.

Key words: Mycobacterium tuberculosis, Infectious disease incubation period, Diagnosis, Protective agents

中图分类号:

R52
R184.6

马艳, 陆伟, 高磊, 初乃惠, 周林, 成诗明. 终止结核病流行须加强结核分枝杆菌潜伏感染高危人群筛查和预防性治疗的管理[J]. 中国防痨杂志, 2022, 44(3): 209-214. doi: 10.19982/j.issn.1000-6621.20220008

MA Yan, LU Wei, GAO Lei, CHU Nai-hui, ZHOU Lin, CHENG Shi-ming. To end tuberculosis epidemic needs strengthen the management of screening and preventive treatment of latent tuberculosis infection in high-risk groups[J]. Chinese Journal of Antituberculosis, 2022, 44(3): 209-214. doi: 10.19982/j.issn.1000-6621.20220008

参考文献 24

[1]	Hartman-Adams H, Clark K, Juckett G. Update on latent tuberculosis infection. Am Fam Physician, 2014, 89(11):889-896. pmid: 25077395
[2]	World Health Organization. Global tuberculosis report 2015. Geneva: World Health Organization, 2015.
[3]	World Health Organization. Global tuberculosis report 2021. Geneva: World Health Organization, 2021.
[4]	中国医学科学院病原生物学研究所, 中国疾病预防控制中心, 中国科学院地理科学与资源研究所. 全国结核分枝杆菌潜伏感染率估算专家共识. 中国防痨杂志, 2022, 44(1):4-8. doi: 10.19982/j.issn.1000-6621.20210662. doi: 10.19982/j.issn.1000-6621.20210662
[5]	Oxlade O, Benedetti A, Adjobimey M, et al. Effectiveness and cost-effectiveness of a health systems intervention for latent tuberculosis infection management (ACT4): a cluster-randomised trial. Lancet Public Health, 2021, 6(5):e272-e282. doi: 10.1016/S2468-2667(20)30261-9. doi: 10.1016/S2468-2667(20)30261-9 URL
[6]	World Health Organization. WHO consolidated guidelines on tuberculosis Module 2: screening-systematic screening for tuberculosis disease. Geneva: World Health Organization, 2020.
[7]	Stagg HR, Zenner D, Harris RJ, et al. Treatment of latent tuberculosis infection: a network meta-analysis. Ann Intern Med, 2014, 161(6):419-428. doi: 10.7326/M14-1019. doi: 10.7326/M14-1019 URL
[8]	World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2018.
[9]	World Health Organization. WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment. Geneva: World Health Organization, 2020.
[10]	中华人民共和国国家卫生健康委员会办公厅. 国家卫生健康委办公厅关于印发中国结核病预防控制工作技术规范(2020年版)的通知.国卫办疾控函〔2020〕279号. 2020-04-02.
[11]	World Health Organization. WHO guidelines on tuberculosis infection prevention and control: 2019 update. Geneva: World Health Organization, 2019.
[12]	Martinez L, Cords O, Horsburgh CR, et al. The risk of tuberculosis in children after close exposure: a systematic review and individual-participant meta-analysis. Lancet, 2020, 395(10228):973-984. doi: 10.1016/S0140-6736(20)30166-5. doi: 10.1016/S0140-6736(20)30166-5 URL
[13]	洪可, 张定宇, 阮连国. 武汉市HIV/AIDS患者潜伏性结核感染筛查及预防效果. 传染病信息, 2021, 34(5):422-425. doi: 10.3969/j.issn.1007-8134.2021.05.008. doi: 10.3969/j.issn.1007-8134.2021.05.008
[14]	梁瑞英, 徐伟, 吴春萍. 北京市朝阳区2013—2015年高校新生结核菌潜伏感染现状及发病情况. 中国学校卫生, 2019, 40(9):1373-1375,1379. doi: 10.16835/j.cnki.1000-9817.2019.09.026. doi: 10.16835/j.cnki.1000-9817.2019.09.026
[15]	郭倩文, 朱晓敏, 朱芳, 等. 接尘作业工人尘肺患者结核潜伏性感染的患病情况及影响因素分析. 实用预防医学, 2020, 27(9):1122-1124. doi: 10.3969/j.issn.1006-3110.2020.09.027. doi: 10.3969/j.issn.1006-3110.2020.09.027
[16]	Sepehri N, Saghanezhad SM, Khoddami F, et al. Meta-analysis of latent tuberculosis in healthcare workers in Iran: a retrospective review. Trans R Soc Trop Med Hyg, 2021, 115(9):965-974. doi: 10.1093/trstmh/trab006. doi: 10.1093/trstmh/trab006 URL
[17]	张霞, 汤泓. 上海市长宁区老年糖尿病患者结核潜伏感染现况和预防性治疗态度. 中国热带医学, 2021, 21(5):408-412. doi: 10.13604/j.cnki.46-1064/r.2021.05.03. doi: 10.13604/j.cnki.46-1064/r.2021.05.03
[18]	Basera TJ, Ncayiyana J, Engel ME. Prevalence and risk factors of latent tuberculosis infection in Africa: a systematic review and meta-analysis protocol. BMJ Open, 2017, 7(7):e012636. doi: 10.1136/bmjopen-2016-012636. doi: 10.1136/bmjopen-2016-012636 URL
[19]	卢水华, 陆伟. 新型结核菌素皮肤试验使用手册. 北京: 人民卫生出版社, 2021.
[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. doi: 10.3969/j.issn.1000-6621.2021.09.004
[21]	中国防痨协会, 中国防痨协会学校与儿童结核病防治专业分会, 《中国防痨杂志》编辑委员会. 重组结核杆菌融合蛋白(EC)临床应用专家共识. 中国防痨杂志, 2020, 42(8):761-768. doi: 10.3969/j.issn.1000-6621.2020.08.001. doi: 10.3969/j.issn.1000-6621.2020.08.001
[22]	祁雪, 田建岭, 孙琳, 等. 儿童结核分枝杆菌潜伏感染的筛查和预防性治疗. 中国防痨杂志, 2018, 40(5):447-454. doi: 10.3969/j.issn.1000-6621.2018.05.003. doi: 10.3969/j.issn.1000-6621.2018.05.003
[23]	刘惠, 闻颖. 艾滋病患者和HIV感染者中结核潜伏性感染的诊断与预防性治疗. 中国防痨杂志, 2016, 38(1):57-60. doi: 10.3969/j.issn.1000-6621.2016.01.013. doi: 10.3969/j.issn.1000-6621.2016.01.013
[24]	舒薇, 孙玙贤, 张立杰, 等. 结核病的研究与创新——2021年世界卫生组织全球结核病报告解读. 中国防痨杂志, 2022, 44(1):45-48. doi: 10.19982/j.issn.1000-6621.20210685. doi: 10.19982/j.issn.1000-6621.20210685

终止结核病流行须加强结核分枝杆菌潜伏感染高危人群筛查和预防性治疗的管理

To end tuberculosis epidemic needs strengthen the management of screening and preventive treatment of latent tuberculosis infection in high-risk groups

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