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背景:在巴西,对于潜伏结核感染(LTBI)的治疗只应用于那些接触痰菌涂阳患者、年龄小于15岁、结核菌素皮试(TST)结果≥10mm、没有接种过卡介苗(BCG)的人群以及那些无论是否接种过BCG但TST结果≥15mm的接触者。目的:评估2年发病率和不符合巴西LTBI治疗标准的结核病接触者中的一些预测指标。设计:人群回顾性研究。12～15岁接触者以及那些>15岁但不符合巴西LTBI治疗标准者进入研究范围。结果:结核病发病率为3.2%(22/667),估计结核病发病率为1649/10万;349例TST结果≥5mm接触者(5.4%)发病的危险性高于318例TST结果<5mm接触者(0.9%;RR6.04,95%CI1.7～20.6)结论:不符合巴西LTBI治疗标准的接触者中,如此高的发病率强烈建议这些标准应重新考虑。另外,即使接种过BCG的接触者,TST硬结≥5mm是唯一的可以预测在2年内发病的变量。
BACKGROUND: In Brazil, treatment of latent tuberculosis (LTBI) is only applicable to patients exposed to smear-positive smears, patients younger than 15 years, TST results ≥10 mm, and BCG-free Populations, and those who have had BCG but have a TST ≥ 15 mm. PURPOSE: To assess some predictors of 2-year morbidity and tuberculosis contacts who do not meet the LTBI treatment criteria in Brazil. Design: People retrospective study. Persons aged 12-15 years and those> 15 years of age who do not meet the criteria for LTBI treatment in Brazil are included in the study. Results: The incidence of tuberculosis was 3.2% (22/667). The estimated incidence of tuberculosis was 1649/10 million. The incidence of 349 cases with ≥5mm contacts with TST (5.4%) was higher than 318 cases with TST <5mm contacts (0.9%; RR 6.04, 95% CI 1.7-20.6). CONCLUSIONS: Of these contacts who do not meet the LTBI treatment criteria in Brazil, such high incidence strongly suggests that these criteria be reconsidered. In addition, TST induration ≥5 mm was the only variable predictive of morbidity within 2 years, even for those exposed to BCG.