Epidemiology of childhood tuberculosis in the United States, 1993-2001: The need for continued vigilance
Epidemiology of childhood tuberculosis in the United States, 1993-2001: The need for continued vigilance
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DOI：
10.1542/peds.114.2.333
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发表时间：
2004-08-01
期刊：
影响因子：
8
通讯作者：
Moore, M
中科院分区：
文献类型：
--
作者：
Nelson, LJ;Schneider, E;Moore, M
Objective.描述美国儿童结核病（TB）的流行病学和临床特征。包括1993 - 2001年向国家结核病监测系统报告的所有经核实的结核病病例。儿童被定义为小于15岁的人。共报告了11480例儿童结核病病例。所有儿童的病例率（结核病例/100 000人口）从1993年的2.9（n = 1 663）下降到2001年的1.5（n = 931）。在儿童中，5岁以下儿童的死亡率最高。加州、德克萨斯和纽约占所有儿童结核病例的48%。2001年，外国出生儿童的结核病发病率（12.2）高于美国出生儿童（1.1）。西班牙裔和非西班牙裔黑人儿童占所有病例的近四分之三。24%的结核病儿童是在国外出生的儿童，其中来自墨西哥（39.8%）、菲律宾（8.6%）和越南（5.7%）的人数最多。大多数儿童有肺结核病的证据（78.9%）。在既往无结核病史的培养阳性病例中，至少对异烟肼耐药的占7.3%，对异烟肼和利福平耐药的占1.6%。1999年，82.9%的儿童接受了至少部分治疗的直接观察治疗，94.8%完成了治疗。尽管美国儿童结核病总病例数正在下降，但某些儿童群体（如年幼儿童、少数民族和外国出生的儿童）患结核病的风险较高。随着美国朝着消除结核病的方向迈进，未来的努力应该奋进预防所有儿童结核病病例。
Objective. To describe trends and highlight epidemiologic and clinical characteristics of childhood tuberculosis ( TB) in the United States.Methods. All verified TB cases reported to the national TB surveillance system from 1993 to 2001 were included. A child was defined as a person younger than 15 years.Results. A total of 11 480 childhood TB cases were reported. Case rates (TB cases/100 000 population) in all children declined from 2.9 (n = 1663) in 1993 to 1.5 (n = 931) in 2001. Among children, those who were younger than 5 years had the highest rate. California, Texas, and New York accounted for 48% of all childhood TB cases. In 2001, TB case rates were higher for foreign-born (12.2) than US-born children (1.1). Hispanic and non-Hispanic black children accounted for nearly three quarters of all cases. Twenty-four percent of children with TB were foreign-born children, with the largest number originating from Mexico (39.8%), the Philippines (8.6%), and Vietnam (5.7%). Most children had evidence of pulmonary TB disease (78.9%). Among culture-positive cases without previous TB, drug resistance to at least isoniazid was 7.3% and to isoniazid and rifampin was 1.6%. In 1999, 82.9% of children received directly observed therapy for at least part of their treatment and 94.8% completed treatment.Conclusions. Although the overall TB case number among children is declining in the United States, certain groups of children (eg, younger children, racial and ethnic minorities, foreign-born) are at higher risk for TB. As the United States moves toward the elimination of TB, future efforts should endeavor to prevent all cases of childhood TB.