终止结核病流行须加强结核分枝杆菌潜伏感染高危人群筛查和预防性治疗的管理

To end tuberculosis epidemic needs strengthen the management of screening and preventive treatment of latent tuberculosis infection in high-risk groups

当前,全球结核病发病率下降缓慢,给实现终止结核病目标带来了严峻的挑战。2020年估算全球结核分枝杆菌潜伏感染人群近20亿,在无预防性治疗干预情况下,其中有5%~10%的感染者在一生中会发展为活动性结核病,在结核病高危人群中发病率更高。世界卫生组织在全球范围内号召推广结核分枝杆菌潜伏感染(LTBI)的预防干预,以实现结核病发病率快速下降的目标。笔者就LTBI流行和预防性治疗的现状、高危人群发病风险、筛查方法、干预和管理建议等进行论述,为制定我国LTBI干预和管理策略及措施提供参考。

Currently,the slow decline of tuberculosis incidence rate becomes a huge challenge to the goal of ending tuberculosis.In 2020,the estimated global latent tuberculosis infection(LTBI)population was nearly 2 billion.With the condition of no preventive intervention,5%to 10%of them will develop into active tuberculosis in the lifetime,and the incidence rate is higher in high-risk population.The World Health Organization has called for the promotion of the prevention of LTBI worldwide,so as to achieve the goal of a rapid decline in the incidence rate of tuberculosis.This paper reviews the current situation of LTBI epidemic and preventive treatment,the incidence risk of high-risk population,screening methods,intervention and management suggestions,etc.,in order to provide reference for formulating LTBI intervention and management strategies and measures in China.