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《中国防痨杂志》精选双语文章推荐
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肺结核是人体肺部感染结核杆菌后引起的慢性呼吸道传染病，是我国发病、死亡人数最多的重大传染病之一。本期精选发表于《中国防痨杂志》的3篇肺结核研究相关双语文章，希望能为相关领域学者提供借鉴与参考，欢迎阅读！ 精选文章selected articles 01 中国重点人群肺结核患病与发病调查分析 study on the prevalence and incidence of pulmonary tuberculosis in high-risk populations in china 【摘要】目的 采用连续筛查的方法，调查我国既往结核病患者、活动性肺结核患者密切接触者、糖尿病患者、hiv/aids者和65岁及以上老年人（简称“五类重点人群”）的结核病患病和发病情况，以及影响因素，为制定重点人群结核病筛查策略提供基础数据。方法 选择全国东、中、西部10个省（市、自治区）的10个县（区）的27个乡镇（社区）作为研究现场，于2013—2015年连续3年对上述五类重点人群进行面对面问卷调查和胸部x线检查。计算这五类重点人群的肺结核患病率和发病密度，并进行不同人口学特征的单因素和多因素分析。结果 2013—2015年分别筛查了38 193、35 305和30 295名。经过3年的连续筛查，全部重点人群的菌阳肺结核患病率下降了28.9%[（246.1-174.9）/246.1×100%]，年递降率为15.7%[√(246.1/174.9-1)×100%]；活动性肺结核患病率下降了32.3%[（746.2-505.0）/746.2×100%]，年递降率为17.7%[√(746.2/505.0-1)×100%]。以2013年为调查基线，全部重点人群随访1年（2014年）发现的菌阳肺结核和活动性肺结核发病密度分别为132.3/10万人年（36/27 202.4）和143.7/10万人年（71/49 393.8），随访2年（2015年）则分别为488.9/10万人年（133/27 202.4）和475.8/10万人年（235/49 393.8）。多因素分析发现：男性、高龄（75～84岁组和≥85岁组）、居住地为农村、少数民族、未婚/离异/丧偶、家庭人均年收入低（2300～9999元）和营养不良（体质量指数<18.5）是结核病患病的危险因素[or（95%ci）值分别为3.4（2.6～4.5）、1.6（1.2～2.2）和2.2（1.3～3.5）、2.0（1.5～2.8）、2.2（1.6～3.0）、1.4（1.1～1.9）、1.8（1.3～2.4）、1.9（1.4～2.6）]，超重（体质量指数≥24）是结核病患病的保护因素[or（95%ci）=0.3（0.2～0.5）]；男性、少数民族和家庭人均年收入低（2300～9999元）是结核病发病的危险因素[ahr（95%ci）值分别为2.5（1.9～3.5)、6.8（4.8～9.6）、1.4（1.0～1.9）]，超重（体质量指数≥24）是结核病发病的保护因素[ahr（95%ci）=0.5（0.4～0.7）]。结论 五类重点人群是我国肺结核患病和发病的高风险人群，在重点人群中应开展主动连续筛查以快速降低结核病疫情。通过危险因素组合可以获得更高风险的目标人群，从而提高筛查收益。 【abstract】objective: to obtain the prevalence, incidence of tuberculosis (tb) and influencing factors among elderly people aged 65 years and older, diabetic patients, people with tb history, close contacts of active tb patients, and hiv/aids patients (referred as “five key populations” hereafter ) in china through continuous screening, and to provide basic evidence for developing screening strategies in key populations. methods: in 27 townships/communities of 10 counties (districts) selected from 10 provincial-level regions located in eastern, central and western regions of china, face-to-face questionnaire surveys and chest x-ray examination were performed on all participants every year for three consecutive years. tb prevalence and incidence density of the five key populations were calculated, and univariate and multivariate analyses of different demographic characteristics were also conducted. results: from 2013 to 2015, 38,193, 35,305 and 30,295 participants were screened respectively. after three years of continuous screening, the prevalence of bacteriologically confirmed tb in all key populations dropped by 28.9% [(246.1 ╟ 174.9)/246.1 × 100%], and the annual decline rate was 15.7%[√(246.1/174.9-1)×100%]; the prevalence of active tb dropped by 32.3% [(746.2 ╟ 505.0)/746.2 × 100%], and the annual decline rate was 17.7%[√(746.2/505.0-1)×100%]. taking survey of 2013 as the baseline, the incidence density of bacteriologically confirmed tb and active tb with 1-year follow-up (2014) in all key populations were 132.3 per 100,000 person-years (36/27,202.4) and 143.7 per 100,000 person-years (71/49,393.8), while with 2-years follow-up (2015), they were 488.9 per 100,000 person-years (133/27,202.4) and 475.8 per 100,000 person-years (235/49,393.8). multivariate analysis found: male, advanced age (group aged 75╟84 and group aged 85 and older), living in rural areas, ethnic minorities, unmarried/divorced/widowed, low annual family income per capita (cny 2300╟9999) and malnutrition (body mass index bmi <18.5) were risk factors for tb ( or (95% ci ) were 3.4 (2.6╟4.5), 1.6 (1.22.2) and 2.2 (1.3╟3. 5), 2.0 (1.5╟2.8), 2.2 (1.6╟3.0), 1.4 (1.1╟1.9), 1.8 (1.3╟2.4) and 1.9 (1.4╟2.6), respectively), and overweight (body mass index ≥24) was a protective factor for tb ( or (95% ci) = 0.3 (0.2╟0.5)). male, ethnic minorities and low annual family income per capita (cny 2300╟9999) were risk factors for the onset of tb ( ahr (95% ci ) were 2.5 (1.9╟3.5), 6.8 (4.8╟9.6), 1.4 (1.0╟1.9)), and overweight (bmi ≥ 24) was a protective factor for the onset of tb ( ahr (95% ci) was 0.5 (0.4╟0.7) ). conclusion: the five key populations are high-risk populations of tb in china. continuous active screening should be carried out in those key populations to quickly reduce the tuberculosis epidemic. through identifying people with different combinations of risk factors, we can set high-risk populations to target at them, thereby to increase the screening benefits. 02 基于社区的重点人群肺结核主动发现干预效果评价：多中心前瞻性队列研究 Evaluation of the effectiveness of community-based pulmonary tuberculosis active case-finding among key populations: a multicenter prospective cohort study 【摘要】目的 评价以社区为基础的结核病重点人群肺结核患者主动发现干预措施的实施效果。方法 采用多中心前瞻性队列研究设计，于2013—2015年在全国东部、中部和西部10个省的27个乡镇（社区），对常住人口中的65岁及以上老年人、已知糖尿病患者、已知hiv/aids者、既往结核病患者和活动性肺结核患者密切接触者五类结核病发病重点人群，每年开展1次以结核病防治核心信息健康宣教、肺结核可疑症状筛查和胸部x线检查为主要手段的患者主动发现，分析不同筛查手段的敏感度和特异度，以及在结核病重点人群中开展肺结核主动发现策略的效果和影响主动发现贡献率的相关因素。结果 在2013—2015年期间，健康教育及肺结核症状筛查的干预完成率分别为97.8%（42 684/43 654）、91.2%（41 732/45 768）和88.1%（42 441/48 178）；胸部x线检查的干预完成率分别为86.0%（37 538/43 654）、81.0%（37 070/45 768）和75.7%（36 483/48 178）。重点人群的结核病防治核心信息知晓率从2013年的34.2%（73 066/213 420）增加到2015年的67.2%（142 629/212 205），呈逐年上升趋势（z趋势=215.568，p<0.01）。只采用规划可疑症状和研究可疑症状进行筛查发现肺结核的敏感度较低[分别为11.6%（69/596）和11.7%（70/596）]，特异度较高[分别为99.1%（125 123/126 261）和99.0%（125 008/126 261）]；只开展胸部x线检查和同时进行研究症状筛查和胸部x线检查的敏感度均为90.7%（594/655），特异度分别为94.2%（104 004/110 436）和93.3%（103 062/110 436）。在发现的活动性肺结核患者中，三年主动发现的患者占全部发现患者的84.9%（556/655），2013年、2014年和2015年主动发现的贡献率分别为95.7%（244/255）、81.0%（200/247）和73.2%（112/153），呈逐年下降的趋势（z趋势=-6.403，p<0.01）。多因素分析结果显示，相对于15～24岁年龄组，55～64岁年龄组[or（95%ci）=7.18（1.59～32.39）]和≥65岁年龄组[or（95%ci）=13.52（3.31～55.16）]主动发现的贡献率较高；与东部地区相比，在西部地区[or（95%ci）=2.44（1.38～4.29）]主动发现的贡献率较高。结论 在社区结核病重点人群中开展每年1次肺结核患者主动发现干预与未开展相比能明显提高肺结核患者的发现水平，特别是在高年龄组和和西部地区其贡献率较高，但贡献率在三年的实施中逐年降低，因此，对同一类人群是否需要每年都采取主动发现的措施要考虑其贡献率的高低。 【abstract】objective: to evaluate the implementation effectiveness of community-based pulmonary tuberculosis (ptb) active case-finding (acf) interventions among key populations. methods: a multi-center prospective cohort study was conducted in 2013╟2015 among five key populations of tuberculosis (1. residents aged 65 and above; 2. residents with diabetes mellitus; 3. residents with hiv/aids; 4. residents with a history of tb; and 5. close contacts of active ptb patients) in selected 27 townships/communities in 10 provincial-level regions located in eastern, central and western regions of china. tb health promotion and education, tb symptom screening, and chest x-ray examination were carried out annually. the sensitivity and specificity of different screening approaches, the effectiveness of acf among different key populations, and factors that influenced acf contributions were analyzed. results: during 2013╟2015, the intervention coverage of health education and tb symptom screening were 97.8% (42,684/43,654), 91.2% (41,732/45,768), and 88.1% (42,441/48,178), respectively; the intervention coverage of chest x-ray examination were 86.0% (37,538/43 654), 81.0% (37,070/45,768), and 75.7% (36,483/48,178), respectively. the tb key message awareness rate increased from 34.2% (73,066/213,420) in 2013 to 67.2% (142,629/212,205) in 2015, showing an upward trend year by year ( ztrend = 215.568, p < 0.01). the sensitivities of symptom screening only were low which could find 11.6% (69/596) of tb cases by using national tb control program defining symptoms and 11.7% (70/596) by using symptoms defined by this study, while specificities were quite high (99.1% (125,123/126,261) and 99.0% (125,008/126,261) respectively). the sensitivities of only using chest x-ray examination and study-defined symptom screening plus chest x-ray were both 90.7% (594/655), and the specificities were 94.2% (104 004/110 436) and 93.3% (103 062/110 436), respectively. among all diagnosed ptb cases, 84.9% (556/655) were detected through acf. the contribution rates of acf in 2013, 2014, and 2015 were 95.7% (244/255), 81.0% (200/247), and 73.2% (112/153), respectively, showing a downward trend year by year ( ztrend = ╟6.403, p < 0.01). the results of multi-variable analysis showed that compared with age group 15╟24, the contribution rates of acf in age group 55╟64 ( or = 7.18; 95% ci: 1.59╟32.39) and age group ≥ 65( or = 13.52; 95% ci: 3.31╟55.16) were higher; compared with the eastern region, the contribution rate of acf in the western region ( or = 2.44; 95% ci: 1.38╟4.29) was higher. conclusion: carrying out an annual community-based acf activity among key populations could significantly increase ptb case detection. the contribution rates of acf were significantly higher in older people and western regions. however, they showed decreasing trends year by year in the three years’ implementation phase. therefore, whether to take acf activities every year for the same group of people should be considered under this group’s specific acf contribution rate. 03 老年人群肺结核主动发现及患者特征分析 analysis on the characteristics of tuberculosis patients detected through active case finding in the elderly 【摘要】目的 分析研究现场老年人群肺结核主动筛查情况和患者特点。方法 通过2013—2019年间4次（分别为2013、2014、2015、2018—2019年）对全国8个县区的12个乡镇/街道（分别为上海市闵行区莘庄镇，江苏省丹阳县导墅镇，浙江省衢州市江山市清湖镇，广东省广州市番禺区东环街道，河南省开封市尉氏县张市镇，黑龙江省哈尔滨市五常县安家镇和常堡乡，四川省绵阳市江油市后坝镇、二郎庙镇、重华镇，广西壮族自治区百色市平果县旧城镇、海城乡）持续居住6个月及以上且满65周岁的老年人群入户开展基本信息调查和肺结核筛查，获得老年人群肺结核患病情况，比较分析患者特点和检出率的变化情况。结果 2018—2019年符合要求的研究对象共36 843名，实际完成胸部x线摄影（简称“胸片”）检查者23 566名，受检率为63.96%；发现活动性肺结核患者82例。老年人群活动性肺结核检出率男性（519.53/10万，56/10 779）明显高于女性（203.44/10万，26/12 780），差异有统计学意义（χ2=16.843，p<0.01）；检出率由65～74岁的275.70/10万（45/16 322）上升至85～113岁的542.01/10万（6/1107），差异有统计学意义（χ趋势2=7.385，p=0.007）；西部地区检出率较高（657.50/10万，66/10 038），活动性肺结核患者密切接触者和既往结核病患者的检出率较高[9547.74/10万（19/199）和1108.03/10万（4/361）]。2013—2019年在相同研究现场开展4次筛查，随着筛查次数的增加，老年肺结核患者痰标本细菌学阳性率[31.43%（55/175）；21.15%（33/156）；35.29%（36/102）；12.20%（10/82）]呈现降低的趋势（χ趋势2=7.290，p=0.007）；4次筛查老年人群活动性肺结核检出率分别为650.49/10万（175/26 903）、618.07/10万（156/25 240）、474.79/10万（102/21 483）和347.96/10万（82/23 566），呈现下降趋势（χ趋势2=25.659，p<0.01）。结论 开展多次主动发现后，老年人群活动性肺结核检出率持续大幅下降，需要根据人群高危因素、筛查频率和方法优化筛查策略。 【abstract】objective: to explore the characteristics of patients and detection rate by active screenings of pulmonary tuberculosis (ptb) in the elderly population in the pilot sites. methods: during 2013╟2019, the basic information and tuberculosis (tb) screening were carried out four times among permanent residents over 65 years old in 12 towns or communities in 8 counties (xinzhuang town, minhang district, shanghai; daoshu town, danyang county, jiangsu province; qinghu town, jiangshan city, quzhou city, zhejiang province; donghuan street, panyu district, guangzhou city, guangdong province; zhangshi town, weishi county, kaifeng city, henan province; anjia town and changbao town, wuchang county, harbin city, heilongjiang province; houba town, erlangmiao town, and chonghua town, jiangyou city, mianyang city, sichuan province; jiucheng town and haicheng town, pingguo county, baise city, guangxi zhuang autonomous region), the prevalence of tb among elderly was obtained and the characteristics of patients and the trend of detection rate were compared. results: from 2018 to 2019, among the 36,843 individuals, 23,566 completed chest x-ray examinations with a screening rate of 63.96%, and 82 patients were diagnosed. the ptb detection rate in the elderly was significantly higher in men (519.53/100,000, 56/10,779) than in women (203.44/100,000, 26/12,780) (χ2 = 16.843, p < 0.01). the detection rate increased with age, from 275.70/100,000 (65╟74 years old group, 45/16,322) to 542.01/100,000 (85╟113 years old group, 6/1107) (χtrend2 = 7.385, p = 0.007). the detection rate was higher in western regions (guangxi and sichuan, 657.50/100,000 (66/10,038)) compared to the counties located in the central and eastern regions of china. the detection rates of close contacts and patients with previously treated tb were significantly higher (9547.74/100,000 (19/199) and 1108.03/100,000 (4/361)) compared to that of non-close contacts and new cases, respectively. from 2013 to 2019, there were four times screenings conducted in the same pilot sites, the bacteriological positive rate of sputum smear in elderly tb patients (31.43% (55/175), 21.15% (33/156), 35.29% (36/102), 12.20% (10/82)) decreased with the year (χtrend2 = 7.290, p = 0.007). the tb detection rate in the elderly was 650.49/100,000 (175/26,903), 618.07/100,000 (156/25,240), 474.79/100,000 (102/21,483), and 347.96/100,000 (82/23,566) respectively, which decreased year by year (χtrend2 = 25.659, p < 0.01). conclusion: after frequent active case finding in the same area, the tb detection rate in the elderly decreased significantly. it reflects high-risk factors, frequency, and screening methods should be considered when an active screening policy is developed. 期刊推荐recommended journal 《中国防痨杂志》创刊于1934年11月，是由中国科学技术协会主管、中国防痨协会主办的国内外公开发行的医学学术期刊，是中国防痨协会的会刊。本刊全面介绍本领域预防控制、临床诊治、基础研究方面的新动态、新进展、新理论、新成果等，以及相关方针、政策。自创刊以来，始终贯彻理论与实践、普及与提高相结合的办刊方针；反映我国结核病预防和控制、基础科研、临床诊疗等方面的重大进展；秉承促进国内外结核病研究领域学术交流的办刊宗旨；坚持在学术上追求高起点、创新性，在技术上追求先进性、实用性和规范化，在信息报导上追求真实性、时效性、可读性；充分发挥学术期刊专家资源优势，打造产、学、研一体化平台。 联系我们contact us 中国知网“中文精品学术期刊外文版数字出版工程”（简称jtp）自2015年启动，已与400余种学术期刊合作出版了4万余篇双语对照论文，积累了丰富的学术翻译/英语加工/学术推广经验。形成了集双语出版、主题电子书出版、双语讲座视频制作、期刊英文内容编校加工、资讯编译、海外推广为一体的全方位服务体系，全面助力期刊提升国际影响力。 感兴趣的朋友请联系 |
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