Updated national guidelines for pediatric tuberculosis in India, 2012
Updated national guidelines for pediatric tuberculosis in India, 2012
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DOI：
10.1007/s13312-013-0085-1
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发表时间：
2013-03-01
影响因子：
2.3
通讯作者：
Prasad, Jagadish
中科院分区：
文献类型：
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作者：
Kumar, Ashok;Gupta, Devesh;Prasad, Jagadish
在国家结核病规划中，儿童结核病（即14岁以下人口中的结核病）传统上受到的重视低于成人结核病，因为其被认为是非传染性的，难以诊断，病例被认为很少，并且错误地认为有效控制成人结核病和使用卡介苗本身可以预防儿童结核病。与传统的国家结核病规划相反，儿童结核病（即，在印度，大约有4亿儿童，占总人口的34%[1]。由于诊断困难，印度儿童结核病的程度尚不清楚;估计占成人总发病率的10.2%[2]。儿童患结核病的最大风险是在1-4岁之间，此时从感染进展为疾病的风险增加。在全球范围内，估计每年发生约100万例儿童结核病病例，占所有结核病的10-15%[3];估计每年有超过10万人死亡，是儿童死亡的十大原因之一。虽然在儿童年龄组中记录了耐多药结核病和广泛耐药结核病，但没有总体负担的估计，主要是因为诊断困难和大多数耐药性调查中排除了儿童。
Pediatric tuberculosis (ie, Tuberculosis (TB) among the population aged less than 14 years) has traditionally received a lower priority than adult TB in National TB programmes because of its considered non-infectious, is difficult to diagnose, cases have been thought to be few and it was wrongly assumed that effective control of adult TB and use of BCG by itself could prevent childhood TB. Contrary to traditional National TB programmes, pediatric tuberculosis (ie., TB among the population aged less than 14 years) has always been accorded high priority by Revised National Tuberculosis Control Programme (RNTCP) since the inception of the programme in our country.In India, there are about~ 400 million children who constitute about 34% of the total population [1]. The extent of childhood TB in India is unknown due to diagnostic difficulties; it is estimated to be 10.2% of the total adult incidence [2]. The maximum risk of a child getting TB is between 1-4 years when there is an increased risk of progression from infection to disease. Globally, about 1 million cases of pediatric TB are estimated to occur every year accounting for 10-15% of all TB [3]; with more than 100,000 estimated deaths every year, it is one of the top 10 causes of childhood mortality. Though MDRTB and XDR-TB is documented among pediatric age group, there are no estimates of overall burden, chiefly because of diagnostic difficulties and exclusion of children in most of the drug resistance surveys.