Evidence-based guidelines for active screening of pulmonary tuberculosis in Chinese communities

doi:10.19982/j.issn.1000-6621.20220321

Abstract

Abstract:

To achieve the goals of the End Tuberculosis Strategy, stronger measures are urgently needed to improve the detection and treatment of tuberculosis, and active screening is an important part of achieving the goals to ensure early diagnosis of tuberculosis. Tuberculosis Control Branch and Elderly Tuberculosis Control Branch of Chinese Antituberculosis Association, and Editorial Board of Chinese Journal of Antituberculosis organized experts to develop the Chinese guidelines for active screening of pulmonary tuberculosis in communities based on the evidence and recommendations of the latest World Health Organization guidelines in 2021. The guidelines also supplemented follow-up newly published literature and relevant literature and research evidence in China. The guidelines systematically summarized the characteristics of active screening techniques such as symptom screening, chest imaging and C-reactive protein, and proposed to conduct pulmonary tuberculosis active screening among close contacts of pulmonary tuberculosis patients, former tuberculosis patients, HIV/AIDS patients, the elderly, diabetic patients, and the general population in epidemic areas. It would provide a basis for the country and localities to improve and optimize the active tuberculosis screening strategy of key populations.

Key words: Mycobacterium tuberculosis, Active screening, Community networks, Public health surveillance, Consensus development conferences as topic

CLC Number:

R521
R81

Tuberculosis Control Branch of Chinese Antituberculosis Association, Elderly Tuberculosis Control Branch of Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis. Evidence-based guidelines for active screening of pulmonary tuberculosis in Chinese communities[J]. Chinese Journal of Antituberculosis, 2022, 44(10): 987-997. doi: 10.19982/j.issn.1000-6621.20220321

Figures/Tables 2

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症状	应用人群	敏感度(%)		特异度(%)
症状	应用人群	估计值	95%CI	估计值	95%CI
长期(慢性)咳嗽	一般人群/高危人群	42	36~48	94	92~96
任意时长咳嗽	一般人群/高危人群	51	43~60	88	82~92
任一结核病症状	一般人群/高危人群	71	62~79	64	52~74
WHO推荐的4种主要结核病症状	HIV感染者	83	74~89	38	25~53

人群	研究数(项)	样本量(例)	敏感度[%(95%CI)]	特异度[%(95%CI)]
所有HIV感染者	6	3971	90(78~96)	50(29~71)
住院患者	1	400	98(93~100)	12(9~17)
正在进行抗病毒治疗的门诊患者	1	381	40(10~80)	80(75~84)
未进行抗病毒治疗的门诊患者	4	3186	89(85~92)	54(45~62)
CD4⁺ T细胞≤200个/μl者	6	1829	93(87~97)	40(22~62)
感染HIV的孕妇	2	62	70(12~97)	41(12~78)