将儿童和青少年纳入结核病诊断发展和评估 - - 一项共识声明
Else M Bijker1, Lyn Horn2, Sylvia LaCourse3
1Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK; Department of Paediatrics, Maastricht University Medical Center, MosaKids Children's Hospital, Maastricht, the Netherlands.
The Lancet. Infectious diseases
|July 6, 2024
概括
为了为儿童开发更好的结核病诊断,从一开始就需要让儿童及其照顾者参与其中. 这确保了新的测试满足了儿童结核病诊断和评估的独特需求.
科学领域:
- 儿童传染病 儿童传染病
- 诊断的发展 诊断的发展
- 全球卫生健康 全球卫生健康
背景情况:
- 由于非特异性症状和低细菌负载,儿童结核病的诊断具有挑战性.
- 当前的诊断发展往往忽视了儿童和青少年的特定需求.
- 缺乏关于将儿科患者纳入诊断评估的指导.
研究的目的:
- 建立关于将儿童和青少年纳入结核病诊断开发和评估的共识.
- 为将儿科考虑纳入整个诊断生命周期提供指导.
- 加速为儿童开发有效的结核病诊断.
主要方法:
- 一个德尔菲的共识过程,涉及42个利益相关者.
- 包括一个定性和两个定量轮来达成协议.
- 专注于制定关于儿童包括在诊断发展中的陈述.
主要成果:
- 在20个声明上达成共识.
- 在整个设计和评估过程中,儿童,青少年和护理人员的观点至关重要.
- 确定了早期样本使用和潜在招生机会,考虑了测试类型,好处和风险.
结论:
- 基于病原体的测试可能在成年人/青少年中得到优化,但基于宿主的测试需要并行儿科评估.
- 后期研究应侧重于组合测试和临床整合.
- 开发人员,研究人员,监管机构和用户之间的合作对于推进儿科结核病诊断至关重要.
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