Secondary Attack Rate of Tuberculosis in Urban Households in Kampala, Uganda 英文参考文献.docVIP

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Secondary Attack Rate of Tuberculosis in Urban Households in Kampala, Uganda 英文参考文献.doc

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Secondary Attack Rate of Tuberculosis in Urban Households in Kampala, Uganda 英文参考文献

SecondaryAttackRateofTuberculosisinUrban HouseholdsinKampala,Uganda ChristopherC.Whalen1*,SarahZalwango2,AllanChiunda1,LaShaundaMalone3,KathleenEisenach4, MosesJoloba2,W.HenryBoom3,RoyMugerwa5 1DepartmentofEpidemiologyandBiostatistics,CollegeofPublicHealth,UniversityofGeorgia,Athens,Georgia,UnitedStatesofAmerica,2TuberculosisResearchUnit, MakerereUniversity,Kampala,Uganda,3DepartmentofMedicine,CaseWesternReserveUniversity,SchoolofMedicineandUniversityHospitalsofCleveland,Cleveland, Ohio,UnitedStatesofAmerica,4DepartmentofPathology,UniversityofArkansasforMedicalSciences,LittleRock,Arkansas,UnitedStatesofAmerica,5Departmentof Medicine,MakerereUniversityMedicalSchool,Kampala,Uganda Abstract Background:Tuberculosisisanancientdiseasethatcontinuestothreatenindividualandpublichealthtoday,especiallyin sub-Saharan Africa. Current surveillance systems describe general risk of tuberculosis in a population but do not characterizetherisktoanindividualfollowingexposuretoaninfectiouscase. Methods: In a study of household contacts of infectious tuberculosis cases (n=1918) and a community survey of tuberculosisinfection(N=1179)inKampala,Uganda,weestimatedthesecondaryattackratefortuberculosisdiseaseand tuberculosis infection. The ratio of these rates is the likelihood of progressive primary disease after recent household infection. Results: The secondary attack rate for tuberculosis disease was 3.0% (95% confidence interval: 2.2, 3.8). The overall secondaryattackratefortuberculosisinfectionwas47.4(95%confidenceinterval:44.3,50.6)anddidnotvarywidelywith age,HIVstatusorBCGvaccination.TheriskforprogressiveprimarydiseasewashighestamongtheyoungorHIVinfected andwasreducedbyBCGvaccination. Conclusions:EarlycasedetectionandtreatmentmaylimithouseholdtransmissionofM.tuberculosis.Householdmembers athighriskfordiseaseshouldbeprotectedthroughvaccinationortreatmentoflatenttuberculosisinfection. Citation: Whalen CC, Zalwango S, Chiunda A, Malone L, Eisenach K, et al. (2011) Secondary Attack Rate