在家庭暴露于Mycobacterium tuberculosis的儿童中无症状结核病
Humphrey Mulenga1, Justin Shenje1, Simon C Mendelsohn1
1South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
概括
无症状结核病 (TB) 在暴露于结核病的幼儿中很常见. 在所有暴露接触者中,无论症状如何,积极调查儿童结核病至关重要,以确保及时诊断和治疗.
科学领域:
- 儿童传染病 儿童传染病
- 公共卫生 公共卫生
- 结核病的研究研究.
背景情况:
- 无症状结核病 (TB) 经常在成年人中观察到,但由于诊断局限性,在儿童中研究不足.
- 目前针对儿童结核病的诊断方法往往排除无症状个体,造成知识差距.
研究的目的:
- 调查幼儿无症状结核病 (TB) 的患病率和特征,这些儿童在家庭中暴露于感染性成年人.
- 评估诊断标准在识别无症状儿童的结核病中的有用性.
主要方法:
- 南非的一项研究招募了430名家庭结核病暴露的儿童 (2-60个月),不包括艾滋病毒感染儿童.
- 方法包括症状查,胸部放射 (CXR) 和诱导分析.
- 确认和未确认的结核病被定义使用共识病例定义,无症状结核病被定义为满足没有报告症状的标准.
主要成果:
- 154名 (35.8%) 儿童符合结核病诊断标准;55名 (35.7%) 的结核病病例无症状.
- 与有症状的病例相比,无症状病例的胸部X射线图与结核病相容率 (73.2%) 较高.
- 80%的无症状结核病患者开始接受结核病治疗,而34%的有症状患者开始接受结核病治疗.
结论:
- 无症状结核病,符合共识病例定义,在暴露于结核病的儿童中普遍存在.
- 建议在所有家庭接触儿童中积极调查结核病,无论症状存在,以指导治疗决策.
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