从密切接触者管理看结核感染预防性治疗与结核病控制策略

Preventive treatment for tubercle infection and the tuberculosis control strategy

现行肺结核患者密切接触者筛查仅进行症状筛查,不能满足结核病控制工作的需要。结核病的密切接触者管理可以延伸为对结核感染者的干预与管理。预防性治疗是降低结核感染者发病风险的最可靠手段。预防性治疗应针对发病风险高的重点人群。只有较高的预防性治疗覆盖完成率才能有效降低人群发病风险,保证人群应用效果。须从结核病控制策略层面保障结核感染筛查的规范开展以及预防性治疗的覆盖率和完成率,才能发挥预防性治疗降低人群结核病发病率的作用。

The crucial shortcoming of current tuberculosis control strategy is inadequate management of close contacts of tuberculosis patients.Close contacts management means intervention and management for tubercle infected persons.Preventive treatment is a reliable means to decrease the risk for tubercle infected persons to develop active tuberculosis.Preventive treatment should focus on the high-risk groups.Only high coverage of preventive treatment can effectively lower the population tuberculosis incidence and ensure its efficacy in the crowd.It is essential to guarantee standard tubercle infection screening,high coverage and complement of preventive treatment at the tuberculosis control strategy level,to sufficiently make use of preventive treatment to lower the population tuberculosis incidence.