Low case notification rates of childhood tuberculosis in southern Ethiopia.
Low case notification rates of childhood tuberculosis in southern Ethiopia.
复制标题
DOI：
10.1186/s12887-015-0461-1
复制
发表时间：
2015-10-01
期刊：
影响因子：
2.4
通讯作者：
Lindtjørn B
中科院分区：
文献类型：
--
作者：
Dangisso MH;Datiko DG;Lindtjørn B
儿童结核病(TB)是一个公共卫生问题，导致相当大的死亡率。然而，儿童结核病的控制很少受到关注。控制努力可能不充分，因为在儿童中诊断这种疾病的困难带来了挑战。了解该疾病在儿童中的负担对于评估该疾病在社区中的持续传播和改进结核病控制工作非常重要。开展这项研究是为了评估十年期间15岁以下儿童的结核病病例通知率(CNR)和治疗结果。数据是从埃塞俄比亚Sidama区提供结核病治疗的所有卫生设施的单位结核病登记中收集的。我们按年龄、性别和居住地分析了CNRS和治疗结果。我们使用Logistic回归分析来确定与治疗结果相关的因素，并控制混淆。共有4656例15岁以下儿童被报告诊断和治疗结核病，占研究区所有报告结核病病例的13.5%。每10万名15岁以下儿童的平均CNR为：所有新发结核病病例30例，农村病例28例，城市病例67例，男孩28例，女孩32例。在整个研究期间，新病例的治疗成功率为82%，再治疗病例的成功率为77%，2012年新病例的治疗成功率增加到93%(X2Trend，P <； 0.001)。5岁以下儿童的治疗成功率较低[调整后的优势比(AOR)为0.64(95%CI，0.52-0.80)]，死亡率较高[AOR 2(95%CI，1.27-3.12)]。2岁以下儿童在治疗过程中死亡的儿童比例是2岁及以上儿童的3倍[AOR 3.34(95%CI，1.92-5.82)]。锡达玛儿童结核病的CNR较低。5岁以下儿童的死亡比例更高。需要努力改善儿童结核病的诊断和治疗。本文的在线版本(doi：10.1186/s12887-0150461-1)包含补充材料，授权用户可以使用。
Childhood tuberculosis (TB) is a public health concern causing considerable mortality. However, control of childhood TB receives little attention. The control efforts could be inadequate because of challenges associated with difficulties in diagnosing the disease in children. Understanding the burden of the disease among children is important to assess the ongoing transmission of the disease in a community and improving TB control efforts. This study was carried out to assess TB case notification rates (CNRs) and treatment outcomes in children aged less than 15 years over a ten-year period. Data were collected from unit TB registers from all health facilities providing TB treatment in the Sidama Zone in Ethiopia. We analysed the CNRs and treatment outcomes by age category, gender, and place of residence. We used logistic regression analysis to identify factors associated with treatment outcomes and to control for confounding. A total of 4,656 cases of children less than 15 years of age were notified as diagnosed and treated for TB, constituting 13 % of all notified TB cases in the study area. The mean CNRs per 100,000 children less than 15 years were 30 for all new cases of TB, 28 for rural cases, 67 for urban cases, 28 in boys, and 32 in girls. The proportions of treatment success were 82 % for new and 77 % for retreatment cases for the entire study period and increased to 93 % for new cases in 2012 (X2trend, P < 0.001). Children less than five years old had a lower treatment success [adjusted odds ratio (AOR) 0.64 (95 % CI, 0.52-0.80)] and higher deaths [AOR 2 (95 % CI, 1.27–3.12)]. The proportion of children who died during treatment among children in the less than 2-year-old age group was three times higher than children in the 2 year and above age groups [AOR 3.34 (95 % CI, 1.92–5.82)]. The CNRs of childhood TB were low in Sidama. Children less than 5 years old had a higher proportion of deaths. Efforts need to be made to improve the diagnosis and treatment of TB among children. The online version of this article (doi:10.1186/s12887-015-0461-1) contains supplementary material, which is available to authorized users.