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背景:高结核病流行的南墨西哥社区。目的:为描述以DOTS为基础的控制规程地区结核病传播的动态特征。设计:以社区为基础筛选1995年3月1日至1996年8月31日期间有慢性咳嗽者。登记、会见痰抗酸杆菌(AFB)阳性的病人,并做分支杆菌培养和指纹。对所有做DNA指纹的人进行详细访问。结果:在进行抗酸杆菌涂片的1 424人中,有124人得到微生物学确认。获得95名病例的细菌DNA指纹,其中38例是成簇的。最大的一簇包括集中在几个未登记酒吧的7名社会网络成员。结论:这个以人群为基础的分子流行病学研究表明,在社会网络内的传播中,四分之一很快地发展成为疾病。这些观察对在卫生区域内实施WHO解释的DOTS规范的结核病控制措施的潜在利益提出了疑问。
Background: High prevalence of tuberculosis in southern Mexico. Purpose: To characterize the dynamics of TB transmission in DOTS-based control procedures. Design: Screening for community-based chronic cough from March 1, 1995 to August 31, 1996. Register, meet sputum acid-fast bacilli (AFB) -positive patients, and do mycobacterial culture and fingerprinting. Make detailed access to all those who do DNA fingerprinting. Results: Of the 1 424 people who took the acid-fast bacilli smear, 124 were confirmed by microbiology. Bacterial DNA fingerprinting was obtained in 95 cases, of which 38 were clustered. The largest cluster includes seven members of the social network that focus on several unregistered bars. Conclusion: This population-based molecular epidemiological study shows that one in four in the spread of social networks rapidly develops into disease. These observations raise questions about the potential benefits of implementing DOTS-regulated tuberculosis control measures as defined by the WHO within the health area.