Andersen P H, Thomsen V Ø, Smith E
Statens Serum Institut, København, epidemiologisk afdeling og mykobakteriologisk laboratorium.
Ugeskr Laeger. 2001 Nov 26;163(48):6739-42.
During a century with a decreasing incidence of tuberculosis (TB) in Denmark, the last 15 years have seen an increase. We describe the epidemiology of TB in children in Denmark with the focus on the impact of immigration.
Data from the national TB surveillance of 1990-1999 were analysed. The variables were age, gender, nationality, TB location(s), and the results of microscopy and culture.
Three hundred and forty-nine children below 15 years of age were found, representing 8% of all notified cases of TB. Of these, 268 children (78%) were immigrants. The number of children increased over time, as did the proportion of immigrants (p < 0.0001). The median age was four years in the native Danes and nine years in the immigrant children (p < 0.001). The mean annual incidence of TB in the children was 3.9 per 10(5); 45.8 per 10(5) in the immigrants and 0.92 per 10(5) in the native Danes. The incidence increased from 2.0 in 1990 to 5.3 per 10(5) in 1999. Forty-nine per cent of the immigrants were Somalis, 13% were Pakistanis. The mean annual TB incidence was 581 per 10(5) in Somalis and 78 per 10(5) in Pakistanis. The incidence increased with age in children from Pakistan and Somalia and decreased in native Danes. Seventy-seven per cent of native Danes and 65% of immigrants had pulmonary TB +/- other locations (p < 0.05). Sixty-seven per cent of immigrant children with extrapulmonary TB had TB in the glands, 9% had TB in the bones, and another 9% had TB in the digestive system, proportions that were 38% (p < 0.05), 8%, and 0%, respectively, in native Danes.
Immigration has had an impact on the incidence of TB, as well as on the pattern of TB location in children in Denmark. The incidence was 48 times higher in immigrant than in native Danish children.
在丹麦，结核病（TB）发病率在一个世纪中呈下降趋势，但在过去15年中有所上升。我们描述丹麦儿童结核病的流行病学情况，重点关注移民的影响。
分析了1990 - 1999年全国结核病监测数据。变量包括年龄、性别、国籍、结核病发病部位以及显微镜检查和培养结果。
发现15岁以下儿童349例，占所有报告结核病病例的8%。其中，268名儿童（78%）为移民。儿童数量随时间增加，移民比例也增加（p < 0.0001）。丹麦本土儿童的中位年龄为4岁，移民儿童为9岁（p < 0.001）。儿童结核病的年平均发病率为每10万人口3.9例；移民中为每10万人口45.8例，丹麦本土儿童为每10万人口0.92例。发病率从1990年的每10万人口2.0例增至1999年的每10万人口5.3例。49%的移民是索马里人，13%是巴基斯坦人。索马里人的结核病年平均发病率为每10万人口581例，巴基斯坦人为每10万人口78例。来自巴基斯坦和索马里的儿童发病率随年龄增长，而丹麦本土儿童发病率下降。77%的丹麦本土儿童和65%的移民患有肺结核±其他部位病变（p < 0.05）。67%的肺外结核移民儿童结核病变位于淋巴结，9%位于骨骼，另有9%位于消化系统，而丹麦本土儿童相应比例分别为38%（p < 0.05）、8%和0%。
移民对丹麦儿童结核病发病率及发病部位模式均有影响。移民儿童的发病率比丹麦本土儿童高48倍。
