New approaches and emerging technologies in the diagnosis of childhood tuberculosis
New approaches and emerging technologies in the diagnosis of childhood tuberculosis
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DOI：
10.1016/j.prrv.2007.04.002
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发表时间：
2007-06-01
影响因子：
5.8
通讯作者：
Pai, Madhukar
中科院分区：
文献类型：
--
作者：
Marais, Ben J.;Pai, Madhukar
儿童结核病长期以来一直被结核病控制规划所忽视，因为儿童往往会患上痰涂片阴性疾病，很少会导致疾病传播。然而，在结核病流行地区，儿童患有严重的结核病相关发病率和死亡率，并在全球疾病负担中占很大比例。除了改善对全球结核病流行的控制外，获得准确诊断和有效治疗对于减少与儿童结核病相关的疾病负担至关重要。对儿童友好的抗结核治疗的可及性正在改善，但确定准确的诊断仍然是一项挑战。本文综述了儿童结核病诊断的最新进展，重点介绍了细菌学、免疫学、放射学和基于症状的方法。即使在资源有限的环境中，也有可能对免疫能力强的儿童进行相当准确的潜伏性感染或活动性结核病诊断，但对感染艾滋病毒（免疫功能低下）的儿童进行结核病准确诊断仍然是一项重大挑战。(c) 2007 Elsevier Ltd.版权所有。
Childhood tuberculosis (TB) has long been neglected by TB control programmes, as children tend to develop sputum smear-negative disease and rarely contribute to disease transmission. However, children suffer severe TB-related morbidity and mortality in areas with endemic TB and carry a significant proportion of the global disease burden. Apart from improved control of the global TB epidemic, access to accurate diagnosis and effective treatment is essential to reduce the disease burden associated with childhood TB. Access to child friendly anti-TB treatment is improving, but establishing an accurate diagnosis remains a challenge. This review provides an overview of recent advances in the diagnosis of childhood TB, focusing on bacteriological, immunological, radiological and symptom-based approaches. It is possible to establish a fairly accurate diagnosis of either latent infection or active TB in immunocompetent children, even in resource-limited settings, but establishing an accurate diagnosis of TB in HIV-infected (immunocompromised) children remains a major challenge. (c) 2007 Elsevier Ltd. All rights reserved.