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背景:香港政府结核病与胸部疾病中心的结核病控制规程。 目的:确定香港对结核病家庭接触者的检查结果。 设计:从在胸部疾病中心登记治疗的5757例中随机选择970首发病例,对其所有家庭接触者进行回顾性队列研究。 结果:在确定的2678名家庭接触者(首发病例的3倍)中,检查率为90％;发现41例活动性病例,比率为1720/100000(95％CI1238-2329)。比率在两端年龄组最高,≤5岁的儿童组为3604/100000(95％CI 990-3615),在>60岁年龄组的人群中为3547/100000(95％CI 1456-6489)。痰涂片和培养阳性的首发病例其接触者病例率最高,为2904/100000(95％CI 1869-4873);但细菌学为阴性病人的接触者病例率也高,为1478/100000(95％CI678-2789)。通过接触者追踪确定的阳性病例可能是源病例而不是继发病例。≤5岁的儿童结核菌素为阳性为8％,香港对所有的新生儿都予BCG接种,在过去的30年覆盖率为99％,很难估算这些儿童的感染率。 结论:香港作为结核病的中等负担地区,对接触者进行调查是主动发现活动性病例的一个非常有效的措施。
Background: Tuberculosis Control Regulations of the Hong Kong Government Tuberculosis and Chest Diseases Center. Purpose: To determine the test results of Hong Kong’s contacts with TB family members. DESIGN: A randomized 970 first-episode cases were enrolled from 5,757 patients enrolled in the Chest Disease Center for a retrospective cohort study of all their family contacts. RESULTS: Of the 2678 identified family contacts (three times the first episode), the rate was 90%; 41 active cases were found at a rate of 1720/100000 (95% CI1238-2329). The ratio was highest at both ends of the age group, 3604/100000 (95% CI 990-3615) for children ≤ 5 years and 3547/100000 (95% CI 1456-6489) for those> 60 years of age. The incidence of contact with sputum smear and culture positive cases was the highest (2904/100000) (95% CI 1869-4873), but the incidence of contact with bacteriologically negative patients was also high at 1478/100 000 (95% CI678-2789). Positive cases identified by contact tracing may be the source case rather than the secondary case. Children ≤5 years of age are 8% positive for tuberculin, and all newborns in Hong Kong are vaccinated against BCG. In the past 30 years, the coverage rate was 99%, making it difficult to estimate the prevalence of these children. Conclusion: Hong Kong, as a medium-burden area of TB, investigating contacts is a very effective measure to proactively identify active cases.