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International tuberculosis contact-tracing notifications in Germany: analysis of national data from 2010 to 2018 and implications for efficiency.
BMC Infectious Diseases ( IF 3.4 ) Pub Date : 2020-04-06 , DOI: 10.1186/s12879-020-04982-z
Saskia Glasauer 1 , Stefan Kröger 2 , Walter Haas 2 , Nita Perumal 2
Affiliation  

International contact-tracing (CT) following exposure during long-distance air travel is resource-intensive, whereas evidence for risk of tuberculosis (TB) transmission during international travel is weak. In this study, we systematically analyzed the information from international requests for CT received at the national level in Germany in order to evaluate the continued utility of the current approach and to identify areas for improvement. An anonymized archive of international CT notifications received by the Robert Koch Institute between 2010 and 2018 was searched for key parameters for data collection. A total of 31 parameters, such as characteristics of TB patients and their identified contacts, were extracted from each CT notification and collated into a dataset. Descriptive data analysis and trend analyses were performed to identify key characteristics of CT notifications, patients, and contacts over the years. 192 CT notifications, each corresponding to a single TB index case, were included in the study, increasing from 12 in 2010 to 41 in 2018. The majority of notifications (N = 130, 67.7%) concerned international air travel, followed by private contact (N = 39, 20.3%) and work exposure (N = 16, 8.3%). 159 (82.8%) patients had sputum smear results available, of which 147 (92.5%) were positive. Of 119 (62.0%) patients with drug susceptibility testing results, most (N = 92, 77.3%) had pan-sensitive TB, followed by 15 (12.6%) with multi-drug resistant TB. 115 (59.9%) patients had information on infectiousness, of whom 99 (86.1%) were considered infectious during the exposure period. 7 (5.3%) patients travelled on long-distance flights despite a prior diagnosis of active TB. Of the 771 contact persons, 34 (4.4%) could not be reached for CT measures due to lack of contact information. The high variability in completeness of information contained within the international CT requests emphasizes the need for international standards for reporting of CT information. With the large proportion of TB patients reported to have travelled while being infectious in our study, we feel that raising awareness among patients and health professionals to detect TB early and prevent international long-distance travel during the infectious disease phase should be a cornerstone strategy to safeguard against possible transmission during international travel.

中文翻译:

德国的国际结核病接触者追踪通知:2010年至2018年国家数据分析及其对效率的影响。

在长途航空旅行中暴露后进行国际接触追踪(CT)是资源密集型的,而在国际旅行期间发生结核病(TB)传播的风险的证据却很少。在这项研究中,我们系统地分析了德国在国家层面收到的来自国际CT需求的信息,以评估当前方法的持续效用并确定需要改进的地方。搜索了罗伯特·科赫研究所(Robert Koch Institute)在2010年至2018年间收到的国际CT通知的匿名档案,以寻找数据收集的关键参数。从每个CT通知中提取了总共31个参数,例如结核病患者的特征及其所识别的接触者,并将其整理到数据集中。进行描述性数据分析和趋势分析,以确定多年来的CT通知,患者和联系人的关键特征。这项研究包括了192例CT通知,每个通知对应一个结核病指数病例,从2010年的12例增加到2018年的41例。大多数通知(N = 130,67.7%)涉及国际航空旅行,其次是私人联系(N = 39,20.3%)和工作暴露(N = 16,8.3%)。有159例(82.8%)的患者可获得痰涂片检查结果,其中147例(92.5%)呈阳性。在119名(62.0%)具有药敏测试结果的患者中,大多数(N = 92,77.3%)患有泛敏感结核病,其次是15名(12.6%)患有多重耐药性结核病。115名(59.9%)患者具有传染性信息,其中99名(86.1%)在接触期间被认为具有传染性。7(5。尽管事先诊断出患有活动性结核病,但仍有3%的患者乘坐长途航班旅行。在771位联系人中,由于缺少联系信息,无法进行CT测量的人数达到了34位(4.4%)。国际CT要求中所包含信息完整性的高度可变性强调了需要国际标准来报告CT信息。在我们的研究中,由于报告说有很大一部分结核病患者在旅行时已经感染,因此我们认为提高患者和卫生专业人员的意识,以便在感染性疾病阶段尽早发现结核病并防止国际长途旅行应该是防止在国际旅行期间可能的传播。由于缺乏联系信息,CT措施无法达到34(4.4%)。国际CT要求中所包含信息完整性的高度可变性强调了需要国际标准来报告CT信息。在我们的研究中,由于报告说有很大一部分结核病患者在旅行时已经感染,因此我们认为提高患者和卫生专业人员的意识,以便在感染性疾病阶段尽早发现结核病并防止国际长途旅行应该是防止在国际旅行期间可能的传播。由于缺乏联系信息,CT措施无法达到34(4.4%)。国际CT要求中所包含信息完整性的高度可变性强调了需要国际标准来报告CT信息。在我们的研究中,由于报告说有很大一部分结核病患者在旅行时已经感染,因此我们认为提高患者和卫生专业人员的意识,以便在感染性疾病阶段尽早发现结核病并防止国际长途旅行应该是防止在国际旅行期间可能的传播。国际CT要求中所包含信息完整性的高度可变性强调了需要国际标准来报告CT信息。在我们的研究中,由于报告说有很大一部分结核病患者在旅行时已经感染,因此我们认为提高患者和卫生专业人员的意识,以便在感染性疾病阶段尽早发现结核病并防止国际长途旅行应该是防止在国际旅行期间可能的传播。国际CT要求中所包含信息完整性的高度可变性强调了需要国际标准来报告CT信息。在我们的研究中,由于报告说有很大一部分结核病患者在旅行时已经感染,因此我们认为提高患者和卫生专业人员的意识,以便在感染性疾病阶段尽早发现结核病并防止国际长途旅行应该是防止在国际旅行期间可能的传播。
更新日期:2020-04-22
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