Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic
Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic
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DOI：
10.1186/1471-2334-9-96
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发表时间：
2009-06-17
影响因子：
3.7
通讯作者：
Barennes, Hubert
中科院分区：
文献类型：
--
作者：
Nguyen, Tuan H.;Odermatt, Peter;Barennes, Hubert
背景：结核病在老挝非常普遍（每10万人中有289人）。我们评估了老挝北部农村地区与结核病患者生活在一起的儿童（0-15岁）潜伏性结核病感染（LTBI）的风险。方法：随机选取30个村庄进行横断面调查，追踪结核患者72例，对接触者317人（其中儿童148人）进行问卷调查、结核菌素皮肤试验（阳性：> = 10 mm）、3天抗酸杆菌（AFB）痰液检查和胸片检查。结果：148例接触儿童均未接受预防，1例发生宫颈结核；LTBI的风险为31.0%。患者（31%）及其接触者（31%）对结核病传染性的认识较低，危险行为普遍存在。多因素logistic分析后发现，与痰液阳性成人接触的儿童（OR: 3.3, 95% CI: 1.4-7.7）、治疗前痰液高度阳性的患者（AFB bbb 2+; OR: 4.7, 95% CI: 1.7-12.3）和少数民族（OR: 5.4, 95% CI: 2.2-13.6）的LTBI增加。结论：本研究支持在结核病高流行的偏远地区开展接触者追踪工作的重要性。讨论了提高儿童检出率的建议、现有指南的使用、接触儿童的化学预防以及老挝现有的干预措施。迫切需要改善患者对结核病传染性的教育和认识，以减少结核病的传播。
Background: Tuberculosis is highly prevalent in Laos (289 per 100,000). We evaluated the risk of latent tuberculosis infection (LTBI) among children (0-15 years) living with tuberculosis patients in rural northern Laos.Methods: In a cross sectional survey of 30 randomly selected villages, 72 tuberculosis patients were traced and their 317 contacts (148 were children) investigated using a questionnaire, a tuberculin skin tests (positive: > = 10 mm), a 3-day sputum examination for acid-fast bacilli (AFB), and chest radiography.Results: None of the 148 contact-children received prophylaxis, one had cervical tuberculosis; the risk for LTBI was 31.0%. Awareness of the infectiousness of tuberculosis was low among patients (31%) and their contacts (31%), and risky behavior was common. After multivariate logistic analysis, increased LTBI was found in children with contact with sputum positive adults (OR: 3.3, 95% CI: 1.4-7.7), patients highly positive sputum prior to treatment (AFB > 2+; OR: 4.7, 95% CI: 1.7-12.3), and living in ethnic minorities (OR: 5.4, 95% CI: 2.2-13.6).Conclusion: The study supports the importance of contact tracing in remote settings with high TB prevalence. Suggestions to improve the children's detection rate, the use of existing guidelines, chemoprophylaxis of contact-children and the available interventions in Laos are discussed. Improving education and awareness of the infectiousness of TB in patients is urgently needed to reduce TB transmission.