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地点:结核病高疫情的3所里约热内卢州监狱目的:调查里约热内卢州监狱的患病率,确定危险因素,并探寻在这些州监狱的囚犯中筛查结核病的最适当的方法。方法:里约热内卢的3所监狱里的1696名男性囚犯都进行了系统的胸部X线检查。如果囚犯的X线结果显示肺部、胸膜或纵隔有异常,这些犯人就必须接受痰涂片和痰培养检查。医生将根据细菌学结果做出诊断。如果细菌学结果是阴性,将根据实验性治疗的结果得出诊断结果。结果:结核病患病率为2.7%(46/1696)。32/46(69%)的患者有细菌学证据,其中包括19例涂片阳性的患者。接受检查的囚犯中43%的人胸部X线结果有异常。在logistic回归模型中,结核病的相关因素包括文盲(调整OR 2.10,95%CI 1.02-4.34),咳嗽超过3周(调整OR 2.85,95%CI 1.54-5.27),结核病治疗史(调整OR3.61,95%CI 1.76-7.39),生活在里约热内卢郊区(调整OR 4.54,95%CI 1.02-20.07)和生活在里约热内卢城区(调整OR 5.48,95%CI 1.29-23.33)。在对咳嗽超过3周的囚犯直接进行痰涂片检查,仅发现了46例患者中的9例。结论:结果显示在有条件的情况下应在监狱对入监囚犯进行胸部X线筛查。同时,结果证明了在拘所急需改善环境和医疗条件。
Location: Rio de Janeiro State Prison in 3 High TB Epidemics Objective: To investigate the prevalence of jails in Rio de Janeiro State, identify risk factors and explore the most appropriate method of screening for tuberculosis among prisoners in these state prisons. Methods: A total of 1,696 male inmates in three prisons in Rio de Janeiro conducted a systematic chest X-ray examination. If the prisoners’ X-ray findings indicate abnormalities in the lungs, pleura or mediastinum, these prisoners must undergo sputum smear and sputum culture tests. The doctor will make a diagnosis based on the bacteriological results. If the bacteriological result is negative, the diagnosis will be based on the results of the experimental treatment. Results: The prevalence of tuberculosis was 2.7% (46/1696). 32/46 (69%) patients had bacteriological evidence, including 19 smear-positive patients. Forty-three percent of prisoners under examination had abnormal chest radiographs. In the logistic regression model, tuberculosis related factors included illiteracy (adjusted OR 2.10, 95% CI 1.02-4.34), cough longer than 3 weeks (adjusted OR 2.85, 95% CI 1.54-5.27), history of tuberculosis treatment (adjusted OR 3.61 , 95% CI 1.76-7.39) living in the suburbs of Rio de Janeiro (adjusted OR 4.54, 95% CI 1.02-20.07) and living in downtown Rio de Janeiro (adjusted OR 5.48, 95% CI 1.29-23.33). Direct sputum smear tests were performed on prisoners who coughed for more than 3 weeks, and only 9 of the 46 patients were found. Conclusions: The results show that chest X-ray screening of prisoners in prisons should be conducted in prisons wherever possible. At the same time, the results prove that environmental and medical conditions are urgently needed to be improved.