Smith M H
Tulane University School of Medicine, New Orleans.
J La State Med Soc. 1992 Aug;144(8):375-8.
In children, as in adults, tuberculosis is much commoner among minority population groups, in Louisiana particularly among blacks. Since 1986 tuberculosis in some states has increased notably; in Louisiana the increase is only now, in 1992, becoming apparent. Eighteen new cases in children under 20 were reported in 1991. Diagnosis in children still depends largely on history of contact and on the Mantoux tuberculin test. Treatment has changed markedly to a more intensive 6 month course including three or four drugs. Preventive treatment of tuberculin positive children is particularly emphasized because it will play an important role in achieving the stated public health goal of elimination of tuberculosis by the year 2010. With the increasing number of children exposed to tuberculosis, the increasing number of HIV-positive children at risk, and the rising number of multiresistant tubercle bacilli, vaccination with BCG must be considered.
与成人一样，儿童结核病在少数族裔群体中更为常见，在路易斯安那州，尤其在黑人中更为常见。自1986年以来，一些州的结核病显著增加；在路易斯安那州，这种增加直到1992年才变得明显。1991年报告了18例20岁以下儿童的新病例。儿童结核病的诊断在很大程度上仍依赖于接触史和结核菌素皮试。治疗方法已显著改变，采用更强化的6个月疗程，包括使用三或四种药物。特别强调对结核菌素试验阳性儿童进行预防性治疗，因为这对于实现到2010年消除结核病这一既定公共卫生目标将发挥重要作用。随着接触结核病儿童数量的增加、面临风险的艾滋病毒阳性儿童数量的增加以及多重耐药结核杆菌数量的上升，必须考虑接种卡介苗。
