中国防痨杂志2024，Vol.46Issue(1)：45-53,9.DOI:10.19982/j.issn.1000-6621.20230290
监狱羁押人群中两种结核分枝杆菌潜伏感染检测结果不一致原因及预防性治疗效果分析
Factors for discrepancy between two methods in testing latent tuberculosis infection and effect of preventive anti-tuberculosis treatment among prisoners
摘要
Abstract
Objective:To understand factors associated with discrepancy between interferon-y release assay(IGRA)and Tuberculin Mantoux test(TST),and effect of preventive treatment in preventing tuberculosis incidence among prisoners.Methods:A community-based randomized controlled trail was conducted by selecting five prisons in a city,and allocating separate wards into intervention group and control group in each prison.The control group enrolled 981 participants,who underwent routine Tuberculosis control strategy;the intervention group enrolled 981 participants,who were tested for latent tuberculosis infection(LTBI)using IGRA and TST on the basis of routine tuberculosis control strategy,and the IGRA positive ones were provided preventive treatment under informed consent.All participants were interviewed for epidemiological information,and underwent regular chest X-ray examination every year.We analyzed factors associated with the discrepancy between results of IGRA and TST,and compared tuberculosis incidence in the following three years between the two groups.Results:The consistency between IGRA and TST was 77.93％(745/956).BCG scar(OR=1.477,95％CI:1.068-2.043)was associated with the discrepancy between the two testing methods.In the three years'follow-up,tuberculosis incidence was 0％(0/157)among 157 IGRA positive participants who accepted and all completed preventive anti-tuberculosis treatment,and 2.05％(7/342)among those who did not take preventive treatment(x2=3.259,P=0.071);the tuberculosis incidence was 0％(0/460)among IGRA negative participants,significantly lower than 2.05％(7/342)among the IGRA positive ones who didn't take preventive treatment(x2=9.498,P=0.002);overall,tuberculosis incidence was 0.71％(7/981)in the intervention group and 1.22％(12/981)in control group(x2=1.329,P=0.249).Conclusion:Among prisoners,BCG vaccination is the key factor associated with the discrepancy between IGRA and TST;LTBI testing using IGRA followed by preventive treatment to the positive ones is an effective way to reduce tuberculosis incidence in prisons.关键词
分枝杆菌,结核/结核菌素试验/监狱/诊断,鉴别Key words
Mycobacterium tuberculosis/Tuberculin test/Prison/Diagnosis,differential分类
医药卫生引用本文复制引用
张国钦,魏文亮,张志,张玉华,钟达,张帆..监狱羁押人群中两种结核分枝杆菌潜伏感染检测结果不一致原因及预防性治疗效果分析[J].中国防痨杂志,2024,46(1):45-53,9.基金项目
Tianjin High-level Talent Selection and Training Project in Health Profession(TJSQNYXXR-D2-117) （TJSQNYXXR-D2-117）
Tianjin Health Area Key Reach Project(16KG171)天津市卫生健康行业高层次人才选拔培养工程(TJSQNYXXR-D2-117) （16KG171）
天津市卫生行业重点攻关项目(16KG171) （16KG171）
