儿童和青少年的千里亚结核病:一个范围审查
D Buonsenso1, F Mariani2, R Morello2
1Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy;, Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italy.
概括
儿童的千里亚结核病死亡率很高,特别是在中枢神经系统受到影响时. 诊断方法的敏感性较低,突出显示了儿科军用结核病护理最佳实践的证据差距.
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:
- 结核病 (TB) 是一种严重传播的结核病形式.
- 儿科结核病带来了独特的诊断和管理挑战.
- 有限证据表明,在患有千里亚结核病的儿童中,最优的护理策略是有限的.
研究的目的:
- 综合当前关于儿童和青少年千叶结核病的文献.
- 审查临床表现,诊断,治疗和结果.
- 为未来的研究和政策确定证据缺口.
主要方法:
- 四个数据库 (1950-2023) 的系统文献综述.
- 搜索术语包括"军事"和"传播"的结核病.
- 包括257项涉及1883名儿科患者的研究.
主要成果:
- 中枢神经系统 (CNS) 的参与发生在39.7%的病例中,通常没有神经症状.
- 总体死亡率为30.6%,在1995年之前的研究中更高 (41.5%) 和中枢神经系统参与 (31.9%).
- 诊断测试的灵敏度很低:微生物学确认 (55.8%),结核素皮肤测试 (46.9%),QuantiFERON金 (72.4%).
结论:
- 对于治疗儿科军用结核病存在重大证据缺口.
- 最佳的诊断方法 (例如,腰部穿刺,脑部成像) 仍然不清楚.
- 需要进一步进行高质量的研究,以告知最佳实践和政策.
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