TUBERCULOSIS IN BACILLUS-CALMETTE-GUERIN-IMMUNIZED AND UNIMMUNIZED CHILDREN IN SWEDEN - A 10-YEAR EVALUATION FOLLOWING THE CESSATION OF GENERAL BACILLUS-CALMETTE-GUERIN IMMUNIZATION OF THE NEWBORN IN 1975
TUBERCULOSIS IN BACILLUS-CALMETTE-GUERIN-IMMUNIZED AND UNIMMUNIZED CHILDREN IN SWEDEN - A 10-YEAR EVALUATION FOLLOWING THE CESSATION OF GENERAL BACILLUS-CALMETTE-GUERIN IMMUNIZATION OF THE NEWBORN IN 1975
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DOI：
10.1097/00006454-198703000-00014
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发表时间：
1987-03-01
影响因子：
3.6
通讯作者：
ROMANUS, V
中科院分区：
文献类型：
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作者：
ROMANUS, V
对1969年至1984年瑞典儿童结核病情况进行了分析，包括1975年4月1日停止新生儿卡介苗（BCG）普通免疫接种之前的6.25年和之后的9.75年。每10万名0至4岁儿童的结核病年发病率从2008年的平均1.1例上升到了10万。 1970 年至 1974 年期间，1975 年至 1979 年期间为 1.3 例，1980 年至 1984 年期间为 2.1 例，其中包括在瑞典出生的儿童和在国外出生的儿童。 1975 年 4 月 1 日之后在瑞典出生的儿童中，有 58 名儿童患有结核病（57 名未免疫儿童，1 名已接种卡介苗），即 1984 年（包括 1984 年）每 10 万人年有 1.3 例结核病。 58 名儿童中有 18 名无症状。 13 名儿童出现轻微症状，27 名儿童出现临床症状，其中 2 名儿童出现脑膜炎，1 名儿童死于粟粒感染。截至 1984 年底，与 1969 年至 1974 年间在瑞典出生的主要接受 BCG 免疫的人群相比，1975 年 4 月 1 日之后在瑞典出生的主要未接种疫苗的人群中结核病的相对增加估计为 6.0（95% 置信区间，2.3，16.1）。在瑞典出生的外国父母的未接种卡介苗的儿童中，结核病的发病率比在瑞典父母中出生的儿童高出约 10 倍。瑞典父母所生儿童中本可以预防的结核病病例数量太少，不足以证明重新对新生儿进行一般卡介苗免疫接种是合理的。然而，外国父母的孩子在瑞典出生时仍然需要接受卡介苗免疫保护。
An analysis was made of childhood tuberculosis in Sweden between 1969 and 1984 which included the 6.25 years before and the 9.75 years after the cessation of general Bacillus Calmette-Guerin (BCG) immunization of the newborn on April 1, 1975. The annual incidence of tuberculosis per 100 000 children ages 0 to 4 years increased from an average of 1.1 cases in the period 1970 to 1974 to 1.3 cases in the period 1975 to 1979 and to 2.1 cases in the period 1980 to 1984, including both children born in Sweden and those born abroad. Among children born in Sweden after April 1, 1975, tuberculosis occurred in 58 (57 unimmunized and one BCG-immunized), or 1.3 cases per 100 000 person years up to and including 1984. Eighteen of the 58 chilren were asymptomatic. Minor symptoms were reported in 13 and clinical illness in 27 children, 2 of whom developed meningitis and 1 of whom died of miliary infection. The relative increase in tuberculosis in the mainly unimmunized cohorts born in Sweden after April 1, 1975, compared with the mainly BCG-immunized cohorts born in Sweden in the period 1969 to 1974 was, by the end of 1984, estimated at 6.0 (95% confidence interval, 2.3, 16.1). Tuberculosis was about 10 times more common in non-BCG-immunized children born in Sweden of foreign parents than in those born of Swedish parents. The number of cases of tuberculosis that could have been prevented in children born of Swedish parents was too few to justify the reintroduction of general BCG immunization of the newborn. However, the children of foreign parents still need to be protected by BCG immunization also when they have been born in Sweden.