Int J Tuberc Lung Dis. 2007 Feb;11(2):134-7.
A range of different care providers with varying levels of expertise and experience, including primary care staff, general clinicians, and paediatricians, may be involved in managing children with tuberculosis (TB). Clarifying the roles and responsibilities of health care staff for the diagnosis, treatment and prevention of TB in children is important. Roles and responsibilities depend on the relevant level of the health care system (primary, first referral and second referral). All providers of TB care should manage TB patients in conjunction with the National Tuberculosis Programme (NTP). A key aspect of the overall approach to managing children with TB is that they should always be included in the routine NTP recording and reporting system. This means notifying all identified TB cases in children to the NTP, registering them for treatment and recording their treatment outcome. The WHO Expanded Programme on Immunization (EPI) recommends BCG vaccination as soon as possible after birth in countries with a high TB prevalence. Although there have been several reports of disseminated BCG infection in HIV-infected individuals, BCG appears to be safe in the vast majority of cases. Therefore, in countries with a high TB prevalence (irrespective of the HIV prevalence), the benefits of BCG vaccination outweigh the risks and the WHO recommends a policy of routine BCG immunisation for all neonates.
一系列不同专业水平和经验的医疗服务提供者，包括基层医疗人员、普通临床医生和儿科医生，可能参与到儿童结核病（TB）的管理中。明确医护人员在儿童结核病诊断、治疗和预防方面的角色和职责很重要。角色和职责取决于医疗系统的相关层级（基层、一级转诊和二级转诊）。所有结核病护理提供者都应与国家结核病规划（NTP）共同管理结核病患者。管理儿童结核病总体方法的一个关键方面是，应始终将他们纳入国家结核病规划的常规记录和报告系统。这意味着将所有确诊的儿童结核病病例通报给国家结核病规划，为他们登记治疗并记录治疗结果。世界卫生组织扩大免疫规划（EPI）建议，在结核病高流行国家，婴儿出生后应尽快接种卡介苗。尽管有几例关于艾滋病毒感染者发生播散性卡介苗感染的报告，但在绝大多数情况下卡介苗似乎是安全的。因此，在结核病高流行国家（无论艾滋病毒流行情况如何），卡介苗接种的益处大于风险，世界卫生组织建议对所有新生儿实行常规卡介苗免疫政策。
