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肺部疾病在非洲儿童死于呼吸系统疾病的尸体解剖:一个描述性尸体解剖研究
Chifumbe Chintu1, Victor Mudenda, Sebastian Lucas
1University of Zambia-University College London Medical School Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
Lancet (London, England)
|October 18, 2002
概括
在赞比亚,大多数儿童死于呼吸系统疾病的原因是肺炎和结核病等可预防的感染. 艾滋病毒阳性儿童面临较高风险的肺囊炎肺炎和细胞巨血病毒,需要更新的世卫组织指导方针和更好的诊断.
科学领域:
- 儿童传染病 儿童传染病
- 呼吸系统医学 呼吸系统医学
- 全球健康 全球健康
背景情况:
- 有限的尸检数据存在于非洲儿童患有呼吸系统疾病的特定死亡原因.
- 在赞比亚卢萨卡大学教学医院进行了一项研究,以调查儿童的呼吸道疾病死亡率.
研究的目的:
- 确定导致儿童患有呼吸道疾病死亡的特定肺部疾病.
- 根据年龄和人类免疫缺陷病毒1型 (HIV-1) 状态对发现进行分层.
主要方法:
- 对264名1个月至16岁的儿童 (137名男孩,127名女孩) 的胸腔进行了尸检.
- 儿童根据年龄和HIV-1状态 (阳性或阴性) 分类.
主要成果:
- 最常见的发现是急性发热性肺炎 (39.1%),Pneumocystis carinii肺炎 (27.5%),结核病 (18.8%) 和细胞巨乳病毒 (CMV) 感染 (20.2%).
- 艾滋病毒-1阳性儿童患有Pneumocystis carinii肺炎 (OR 5.28),CMV (OR 7.71) 和冲击肺 (OR 4.15) 的比率显著更高.
- 结核病在所有年龄组和HIV-1状态中普遍存在.
结论:
- 大多数儿科呼吸道死亡是由可治疗的传染病原体造成的.
- 多种疾病的频繁同时发生使得诊断变得复杂.
- 更新的世界卫生组织指导方针和改善的细菌病原体,结核病和Pneumocystis carinii肺炎的诊断工具至关重要,特别是在HIV-1阳性儿童中.
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