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地点:某年末平均人口为9084 名囚犯的监狱系统。目的:确定在一个较长时期内的结核病传播动力学;确定该结核杆菌株是否为监狱系统中结核病流行的主要原因;确定社区病例分离株的成簇性是否和监狱系统有联系。设计:对过去9 年中监狱系统报告的结核病例进行回顾性流行病学分析。另外,将囚犯结核杆菌分离株的IS6110-RFLP 图谱与其它病例进行总体比较。将RFLP 分析结果与流行病学调查结果进行对照。结果:监狱系统中约80%的病例分离株成簇。在过去的9 年中50%以上病例属同一结核杆菌株。社区内由同一株结核杆菌引起的病例与监狱系统存在明显关联。结论:虽然已实行了强有力的结核病控制措施,但是某结核杆菌株仍在监狱系统持续流行。在被诊断和治疗之前,其持留性可使潜伏感染复燃,并感染其他患者,从而使传播链持续下去。
Location: A prison system with an average population of 9,084 prisoners at the end of a year. PURPOSE: To determine the dynamics of tuberculosis transmission over a longer period of time; to determine whether the TB strain is the leading cause of the tuberculosis epidemic in the prison system; and to determine if the clustering of community case isolates is linked to the prison system. Design: A retrospective epidemiological analysis of tuberculosis cases reported by the prison system over the past nine years. In addition, an IS6110-RFLP map of prisoners with M. tuberculosis isolates was compared with other cases as a whole. The results of RFLP analysis and epidemiological survey were compared. Results: About 80% of the case isolates in the prison system are clustered. In the past 9 years, more than 50% of the cases belong to the same tuberculosis strain. There is a clear correlation between the cases in the community caused by the same strain of Mycobacterium tuberculosis and the prison system. Conclusion: Although a substantial TB control measure has been implemented, a TB strain continues to be in the prison system. Persistence can revive a latent infection and infect other patients before it is diagnosed and treated, thus continuing the transmission chain.