在访问朋友和亲戚的儿童中发现结核病
Tomas M Perez-Porcuna1, Antoni Noguera-Julian2, Maria Teresa Riera-Bosch3
1TB Pediatric Unit, Research Foundation of Primary Health and Mútua Terassa University Hospital, Mútua Terrassa, Terrassa, Catalunya 08221, Spain.
Journal of travel medicine
|March 4, 2024
概括
出国探亲的儿童面临着潜伏性结核病感染 (LTBI) 和活动性结核病 (TB) 的重大风险. 家庭吸烟增加了这种风险,突出了对这些儿科患者群体进行有针对性的查和预防的需要.
科学领域:
- 儿童传染病 儿童传染病
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 在发病率较低的国家,儿童结核病 (TB) 病例往往涉及移民家庭的儿童.
- 访问朋友和亲戚 (VFR) 旅行到结核病发病率高的国家是结核病传播的潜在风险因素.
- 对于公共卫生战略来说,估计VFR旅行的儿童潜在结核病感染 (LTBI) 和结核病的风险至关重要.
研究的目的:
- 估计前往父母出生的国家旅行的儿童潜在结核病感染 (LTBI) 和活跃结核病的风险.
- 在这个儿科群体中确定与LTBI相关的风险因素.
主要方法:
- 在西班牙加泰罗尼亚进行的前性多中心观测研究 (2017年6月至2019年12月).
- 登记儿童 (<15岁) 的父母来自高结核病发病率的国家,他们旅行时间≥21天.
- 结核素皮肤测试 (TST) 和QuantiFERON-TB Gold Plus (QFT-Plus) 在返回8-12周后进行;LTBI定义为TST≥5毫米和/或QFT-Plus阳性.
主要成果:
- 在500名儿童中,有13名 (2.6%) 被诊断为LTBI (16.6/100人年随访).
- 两例 (0.4%) 的活跃结核病被诊断为 (2.5/100人年的随访).
- 家庭烟草烟雾暴露与LTBI有显著的关联 (调整后的几率比率=3.9).
结论:
- 那些前往结核病发病率高的国家的VFR旅行的儿童面临着相当大的LTBI风险,可能超过本地人口的LTBI风险.
- 家庭吸烟是从VFR旅行返回的儿童中LTBI的主要风险因素.
- 在高结核病发病率的环境中,建议针对儿童进行针对性的诊断和预防干预.
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