Tuberculosis in children and adolescents: California, 1985 to 1995
Tuberculosis in children and adolescents: California, 1985 to 1995
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DOI：
10.1097/00006454-199805000-00012
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发表时间：
1998-05-01
影响因子：
3.6
通讯作者：
Royce, S
中科院分区：
文献类型：
--
作者：
Lobato, MN;Cummings, K;Royce, S
目标.描述儿童和青少年结核病（TB）的流行病学和临床特征，并确定儿童在TB的风险。设置：4607名0至14岁的儿童和1615名15至19岁的青少年报告与TB在加利福尼亚州。我们分析了1985年至1995年向加州卫生服务部结核病控制分支报告的监测数据。从1985年到1995年，0至4岁儿童的结核病病例增加了22%，5至14岁儿童增加了66%。0至4岁儿童的发病率最高（13/100 000儿童），但从1993年至1995年有所下降，0至4岁黑人儿童除外。0至14岁的少数民族儿童的发病率比白色儿童高6至34倍。肺结核是所有年龄组中最常见的疾病部位（71%至82%）。结核性脑膜炎在0至4岁儿童中最常见（5%）。大多数儿童（64%）没有做过培养;然而，在培养证实的病例中，7%分离出异烟肼耐药结核分枝杆菌。与0 ~ 14岁儿童相比，青少年更容易患空洞性肺病（24%）、出生在国外（78%）或无家可归（4%）以及分离到异烟肼耐药菌株（13%）（P < 0.05）。1980年代中期和1990年代初，儿童和青少年结核病发病率大幅上升。儿童结核病仍然是一个严重的健康问题，特别是在少数民族儿童和青少年中。我们的研究结果表明，结核病控制计划需要改进策略，以预防感染和检测这一人群的疾病。
Objectives. To describe the epidemiology and clinical characteristics of tuberculosis (TB) among children and adolescents and to define children at risk for TB.Setting: 4607 children 0 to 14 years of age and 1615 adolescents 15 to 19 years of age reported with TB in California.Methods. We analyzed surveillance data reported to the California Department of Health Services TB Control Branch from 1985 through 1995.Results. TB cases increased 22% among children 0 to 4 years of age and 66% among children 5 to 14 from 1985 through 1995. Case rates were highest among children 0 to 4 years of age (13/100 000 children), but declined from 1993 to 1995, except for black children 0 to 4 years of age. Minority children 0 to 14 years of age had case rates 6- to 34-fold higher than did white children. Pulmonary TB was the most common site of disease in all age groups (71 to 82%). TB meningitis was most common in children 0 to 4 years of age (5%). Most children (64%) did not have cultures done; however, among culture-proved cases isoniazid-resistant Mycobacterium tuberculosis was isolated in 7%. Adolescents were more likely to have cavitary pulmonary disease (24%), to be foreign-born (78%) or homeless (4%) and to have an isoniazid-resistant strain isolated (13%) than were children 0 to 14 years of age (P < 0.05).Conclusions. TB in children and adolescents increased substantially in the mid-1980s and early 1990s. Pediatric TB remains a serious health problem, especially among minority children and adolescents. Our findings indicate that TB control programs need improved strategies to prevent infection and detect disease in this population.