활동성 폐결핵 환자의 소아청소년 접촉자 조사 결과: 2012년부터 2014년까지 단일 기관의 경험
Outcomes of Child Contact Investigations of Active Pulmonary Tuberculosis Patients: A Single Center Experience from 2012 to 2014
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목적: 본 연구는 결핵 접촉자 조사에서 수집된 자료를 분석하고 그 결과를 평가하고자 계획되었다. 방법: 2012년 8월부터 2014년 7월까지 만 19세 이상의 배양검사 양성인 폐결핵 환자의 소아청소년 접촉자들의 진료기록을 검토하였다. 결과: 배양검사 양성인 폐결핵 환자 79명과 그들의 소아청소년 접촉자 116명이 확인되었다. 확인된 접촉자 116명 중 22%는 접촉자 검진을 중단하였다. 접촉자 검진을 완료한 90명 중 TST 음성이 42%이고TST 양성이 58%였으며, 검진 기간 중 1%가 활동성 폐결핵으로 진단되었다. 항산균 도말 검사 음성 결핵 환자들의 접촉자 50명의 TST 양성률은 50%였다. 5세 이상의 연령(OR 8.3; 95% CI 2.3-30)과 남성(OR 3.9; 95% CI 1.5-9.9)이 접촉자 검진 중단과 유의하게 연관되었다. 결론: 활동성 폐결핵 환자들의 접촉자들을 확인하고 올바르게 검진하기 위해서 접촉자 검진 과정의 개선이 필요하다.
Abstract
Purpose: The study aimed to determine data collected during tuberculosis (TB) contact investigations and to evaluate the outcomes of these investigations. Methods: We reviewed medical records for child contacts of patients with culture-positive pulmonary TB aged 19 years or older between August 2012 and July 2014. Results: A total of 116 child contacts were identified for 79 patients with culture-positive pulmonary TB. Of 116 contacts identified, 22% were incompletely screened. Of 90 contacts who completed screening, 42% had negative tuberculin skin test (TST) results, 58% had positive results, and 1% had active pulmonary TB at the time of investigation. Of 50 contacts with TB patients with a negative smear, 50% had positive TST results. Age ≥5 years (OR 8.3; 95% CI 2.3-30) and male gender (OR 3.9; 95% CI 1.5-9.9) were significantly associated with being incompletely screened. Conclusions: Improvement is needed in the process of contact investigations to ensure that contacts of patients with active pulmonary TB are identified and appropriately screened.
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