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在瑞士儿童接触者中发现结核病例和遵守指南:一项回顾性观察研究
Nathalie Gasser1, Nora Fritschi2,3, Jean-Marie Egger1
1TB Competence Center, Swiss Lung Association, Bern, Switzerland.
Respiration; international review of thoracic diseases
|October 29, 2023
概括
在儿童结核病 (TB) 接触调查中,发现大量儿童患有结核病感染或疾病. 然而,管理层经常偏离国家指导方针,表明需要更好地实施以保护儿童接触.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 与结核病 (TB) 指数病例接触的儿童面临着大量结核病感染和随后疾病的风险.
- 有效的接触调查对于早期检测和预防儿童群体的结核病传播至关重要.
研究的目的:
- 确定儿童接触者发展结核病感染或疾病的比例.
- 评估暴露于结核病的儿童的诊断途径和遵守当前结核病管理指南.
- 确定儿童结核病接触调查协议的改进领域.
主要方法:
- 在2019年1月至2021年7月期间暴露于结核病指数病例的16岁或更年轻的儿童中进行了一项回顾性观察研究.
- 分析了401名暴露儿童中的380名 (95%) 的数据,按年龄组分层:0-4,5-11岁和12-16岁.
主要成果:
- 在分析的380名儿童中,7名 (2%) 被诊断出患有活跃结核病,35名 (9%) 患有结核病感染.
- 观察到与瑞士国家指导方针的显著偏差,包括延迟诊断测试和预防性治疗的不理想处方,特别是在较年轻的儿童 (0-4岁).
- 遵守推的检测计划和预防措施的情况各不相同,只有82%的幼儿及时接受诊断评估,66%的幼儿接受推的预防治疗.
结论:
- 针对结核病的儿科接触调查在识别感染儿童和患有活跃疾病的儿童方面是有效的,即使在发病率低的环境中也是如此.
- 目前的做法显示出与既定指导方针的明显偏差,突出了改善实施和遵守的必要性,以确保儿童结核病接触者的最佳护理.
- 在结核病接触调查中加强国家准则的应用对于减轻暴露儿童结核病感染和疾病进展的风险至关重要.
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