Filippov A V, Ovsiankina E S, Denisova L S, Stakheeva L B
Probl Tuberk Bolezn Legk. 2008(1):6-10.
Tuberculosis morbidity was comparatively analyzed in the children and adolescents of Moscow and the Penza Region. The epidemiology of tuberculosis in the children and adolescents was established to be universal in the compared regions in the study period. This manifested itself as a stable tendency for higher morbidity rates (MR), increased incidence of destructive tuberculosis, inadequate use of the existing methods for active detection of tuberculosis in these age groups, and, among those who had fallen ill with this disease, an increase in the number of persons from the foci of tuberculous infection and persons with established contact with patients with tuberculosis. Along with a steady MR growth for tuberculosis among the children and adolescents, there has been a quantitative modification to the proportion of all epidemiologically hazardous forms of tuberculosis, such as the bacillary and destructive forms of pulmonary tuberculosis complicated by extrapulmonary tuberculosis. Hypodiagnosis of tuberculous pleurisy and extrapulmonary tuberculosis has been recently noted in the general health care network. The analysis also leads to the conclusion that the quality of mass tuberculin diagnosis remains poor. In both regions, general pediatricians are not adequately alert to tuberculosis, extrapulmonary tuberculosis in particular. With a rise in tuberculosis endemic, the incidence of tuberculosis in 18-21-year-old persons is 2-3 times greater than that in adolescents, which is associated with the greater activity of this population group and with the underdetection of the asymptomatic forms of tuberculosis in adolescents.
对莫斯科和奔萨地区的儿童及青少年的结核病发病率进行了比较分析。研究发现,在研究期间,儿童及青少年结核病的流行病学情况在这两个被比较的地区具有普遍性。这表现为发病率(MR)持续偏高、破坏性结核病发病率上升、在这些年龄组中现有结核病主动检测方法使用不足,以及在患此病的人群中,来自结核感染病灶的人数和与结核病患者有明确接触的人数增加。随着儿童及青少年结核病发病率的稳步上升,所有具有流行病学危险性的结核病形式的比例也发生了数量上的变化,例如伴有肺外结核的细菌性和破坏性肺结核形式。近期在普通医疗保健网络中发现了结核性胸膜炎和肺外结核的诊断不足情况。分析还得出结论,大规模结核菌素诊断的质量仍然很差。在这两个地区,普通儿科医生对结核病,尤其是肺外结核的警惕性都不够。随着结核病流行程度的上升,18至21岁人群的结核病发病率比青少年高出2至3倍,这与该人群活动更为频繁以及青少年无症状结核病形式的漏检有关。