Teo S S S, Alfaham M, Evans M R, Watson J M, Riordan A, Sonnenberg P, Clark J, Hayward A, Sharland M, Moore-Gillon J, Novelli V, Quinn D, Shingadia D
Centre for Child Health, University of London, London, UK.
Eur Respir J. 2009 Jul;34(1):176-9. doi: 10.1183/09031936.00031808. Epub 2009 Feb 27.
The sensitivity of the Enhanced Tuberculosis Surveillance (ETS) scheme for monitoring tuberculosis in children is unknown. We used the British Paediatric Surveillance Unit (BPSU) reporting scheme to conduct a prospective observational study of tuberculosis in children aged <16 yrs in the UK. Reported cases were then matched with records from the ETS database. A total of 320 cases were reported to the BPSU between January and December 2004. We estimated that there were 557 paediatric cases in England, Wales and Northern Ireland in 2004: 222 (40%) cases reported to both BPSU and ETS, 98 (18%) reported to BPSU but not ETS and 237 (42%) reported to ETS but not BPSU. Children aged <5 yrs were significantly less likely to be reported to ETS compared with older children (p<0.01). There is substantial under-reporting of childhood tuberculosis, especially of children aged <5 yrs. ETS provides a representative picture of the demographics but may miss approximately 20% of cases. This should be taken into account when planning training and resource requirements for tuberculosis. Increased efforts are needed to ensure that all paediatric cases are reported to ETS.
用于监测儿童结核病的强化结核病监测（ETS）方案的敏感性尚不清楚。我们使用英国儿科监测单位（BPSU）报告方案，对英国16岁以下儿童的结核病进行了一项前瞻性观察研究。然后将报告的病例与ETS数据库中的记录进行匹配。2004年1月至12月期间，共有320例病例报告给了BPSU。我们估计2004年英格兰、威尔士和北爱尔兰有557例儿科病例：222例（40%）同时报告给了BPSU和ETS，98例（18%）报告给了BPSU但未报告给ETS，237例（42%）报告给了ETS但未报告给BPSU。与年龄较大的儿童相比，5岁以下儿童被报告给ETS的可能性显著降低（p<0.01）。儿童结核病存在大量漏报情况，尤其是5岁以下儿童。ETS提供了具有代表性的人口统计学情况，但可能会遗漏约20%的病例。在规划结核病培训和资源需求时应考虑到这一点。需要加大力度确保所有儿科病例都报告给ETS。
