低收入和中等收入国家的呼吸道感染
Lisa Frigati1, Leonore Greybe1, Savvas Andronikou2
1Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
Paediatric respiratory reviews
|September 20, 2024
概括
儿童肺炎 (下呼吸道感染) 仍然是低收入和中等收入国家 (LMICs) 的主要死亡原因. 诊断和治疗方面的进步正在改善理解和管理,但必须增加预防和护理的机会.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 全球健康 全球健康
背景情况:
- 下呼吸道感染 (LRTI) 在低收入和中等收入国家 (LMICs) 的五岁以下儿童中造成显著的死亡率.
- 最近病原发生的变化包括呼吸道同胞病毒 (RSV) 的负担增加以及SARS-CoV-2的影响.
- 结核菌菌 (MTB) 仍然是儿童群体中的关键病原体.
研究的目的:
- 调查LMIC中儿童肺炎的流行病学,病因学,诊断和管理.
- 综合这些地区儿童LRTIs的当前知识.
- 确定改善儿童呼吸系统健康结果的关键挑战和机会.
主要方法:
- 一个全面的评论出版的英语文学.
- 从2019年到2024年2月进行的文献搜索.
- 专注于与LMIC和儿童肺炎相关的研究.
主要成果:
- 在LMICs的5岁以下儿童中,LRTIs的显著死亡率仍然存在.
- RSV是疾病负担的主要贡献者,SARS-CoV-2也具有显著的影响.
- 改进的诊断 (NAAT,快速抗原测试) 提高了MTB和细菌病原体的准确性;护理点诊断显示出希望.
- 建议使用较短的结核病治疗疗程,但缺乏适合儿童的配方.
- 胸部X射线已被认可用于结核病诊断,肺部超声波正在成为具有成本效益的LRTI诊断工具.
结论:
- 诊断和多中心研究的进步加深了对LMIC中LRTI病原体的理解.
- 加强对预防策略 (疫苗),治疗 (抗病毒药物) 的准入,以及解决贫困等社会经济因素对于减少LRTI负担至关重要.
- 需要采用综合方法来进一步降低儿童肺炎死亡率.
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