Pediatric Tuberculosis: Global Overview and Challenges
Pediatric Tuberculosis: Global Overview and Challenges
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DOI：
10.1086/651490
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发表时间：
2010-05-15
影响因子：
11.8
通讯作者：
Rekha, Banu
中科院分区：
文献类型：
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作者：
Swaminathan, Soumya;Rekha, Banu
结核病(TB)是全球儿童死亡的前十大原因之一；然而，在大多数国家卫生计划中，结核病儿童的优先事项较低，在这一流行病中被忽视。在成人结核病诊断方面的最新技术进步尚未在儿童中得到验证。同样，标准一线和二线药物的新药试验和儿科配方的开发也落在了后面。在人类免疫缺陷病毒(HIV)合并感染的儿童中，与抗结核病药物相互作用最小的高效抗逆转录病毒治疗开始和药物组合的最佳时机需要进一步研究。虽然卡介苗是目前唯一可用的结核病疫苗，但它在感染艾滋病毒的人群中的安全性受到了质疑。迫切需要多中心试验来帮助制定改进的诊断策略，并制定更短、更有效、更安全和循证的治疗和预防药物敏感和耐药结核病的方案。
Tuberculosis (TB) is among the top 10 causes of death among children worldwide; however, children with TB are given low priority in most national health programs and are neglected in this epidemic. Recent technological advancements in diagnosis of TB in adults have not been validated in children. Similarly, trials of new drugs and development of pediatric formulations of standard first-and second-line drugs are lagging behind. Among human immunodeficiency virus (HIV)-coinfected children, the optimal timing for highly active antiretroviral therapy initiation and drug combinations that have minimal interactions with anti-TB drugs need further study. Although bacille Calmette-Guerin vaccine, the only vaccine available for TB, protects against disseminated and severe forms of the disease in young children, its safety in the HIV-infected population has been questioned. Multicentric trials are urgently required to help develop improved diagnostic strategies and formulate shorter, more effective, safe, and evidence-based regimens for treatment and prevention of drug-susceptible and drug-resistant TB.