Childhood tuberculosis in northern Viet Nam: a review of 103 cases.
Childhood tuberculosis in northern Viet Nam: a review of 103 cases.
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DOI：
10.1371/journal.pone.0097267
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Nahid P
中科院分区：
文献类型：
--
作者：
Blount RJ;Tran B;Jarlsberg LG;Phan H;Thanh Hoang V;Nguyen NV;Lewinsohn DA;Nahid P
儿童结核病在东南亚造成显著的发病率和死亡率，但对越南这种疾病的流行病学和临床特征知之甚少。确定越南国家转诊医院收治的结核病（TB）儿童的人口统计学、临床表现、影像学和微生物检查结果、治疗方案和结局。我们对2007年1月至12月在越南河內国家转诊医院住院的细菌学确诊或临床诊断为结核病的≤ 15岁儿童进行了一项回顾性病例系列研究。确定了103名儿童：中位年龄5岁（IQR 2-10），44%为女性，99%为京族，27%居住在河內，88%接种了卡介苗，27%已知接触过结核病，38%营养不良。胸内结核占62%，胸外结核占52%，胸内外结核占19%，未确定部位结核占5%。最常见的胸外表现是周围淋巴结炎，5岁以下儿童更可能患有粟粒性结核或胸内和胸外结核。发热和发育不良是所有参与者的常见症状（分别为65%和56%），66%的胸内结核患者出现咳嗽，92%的结核性脑膜炎患者出现严重的神经功能障碍。抗酸杆菌涂片和分枝杆菌培养分别在18%和21%的儿童测试中呈阳性，组织病理学在88%的活检中呈阳性。没有需要改变治疗的药物不良反应，也没有住院患者死亡。胸外结核是常见的，治疗耐受性良好，临床结局极佳。培养确认率低，强调需要改进诊断。
Childhood tuberculosis causes significant morbidity and mortality in Southeast Asia, yet little is known about the epidemiology and clinical characteristics of this disease in Viet Nam. To determine the demographics, clinical presentations, radiographic and microbiologic findings, treatment regimens, and outcomes of children admitted with tuberculosis (TB) to a national referral hospital in Viet Nam. We conducted a retrospective case series study of children ≤ 15 years old with bacteriologically confirmed or clinically diagnosed TB admitted to a national referral hospital in Ha Noi, Viet Nam from January through December 2007. One hundred three children were identified: median age 5 years (IQR 2-10), 44% female, 99% Kinh ethnicity, 27% residing in Ha Noi, 88% with BCG vaccination, 27% with known TB contact, and 38% malnourished. Intrathoracic TB was present in 62%, extrathoracic in 52%, both intra and extrathoracic in 19%, and undetermined site in 5%. The most common extrathoracic manifestation was peripheral lymphadenitis, and children under 5 were more likely to have miliary TB or both intra and extrathoracic TB. Fever and failure to thrive were common presenting symptoms among all participants (65% and 56%, respectively), 66% of those with intrathoracic TB presented with cough, and 92% of those with TB meningitis presented with severe neurologic impairment. Acid-fast bacilli smears and mycobacterial cultures were positive in 18% and 21% of children tested, and histopathology was positive in 88% of those biopsied. There were no adverse drug reactions necessitating change in therapy, and no inpatient mortality. Extrathoracic TB was common, treatment well tolerated and clinical outcomes excellent. Culture confirmation rates were low and emphasize the need for improved diagnostics.
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影响因子：
3.7
作者：
Lolekha, Rangsima;Anuwatnonthakate, Amornrat;Nateniyom, Sriprapa;Sumnapun, Surin;Yamada, Norio;Wattanaamornkiat, Wanpen;Sattayawuthipong, Wanchai;Charusuntonsri, Pricha;Sanguanwongse, Natpatou;Wells, Charles D.;Varma, Jay K.
通讯作者：
Varma, Jay K.
影响因子：
56.3
作者：
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通讯作者：
Kampmann, Beate
影响因子：
11.8
作者：
Marais, BJ;Hesseling, AC;Beyers, N
通讯作者：
Beyers, N
影响因子：
8
作者：
Nelson, LJ;Schneider, E;Moore, M
通讯作者：
Moore, M
影响因子：
5.7
作者：
Feja, K;Saiman, L
通讯作者：
Saiman, L