Tuberculosis Research Centre, Chennai, India.
Clin Infect Dis. 2010 May 15;50 Suppl 3:S184-94. doi: 10.1086/651490.
Tuberculosis (TB) is among the top 10 causes of death among children worldwide; however, children with TB are given low priority in most national health programs and are neglected in this epidemic. Recent technological advancements in diagnosis of TB in adults have not been validated in children. Similarly, trials of new drugs and development of pediatric formulations of standard first- and second-line drugs are lagging behind. Among human immunodeficiency virus (HIV)-coinfected children, the optimal timing for highly active antiretroviral therapy initiation and drug combinations that have minimal interactions with anti-TB drugs need further study. Although bacille Calmette-Guérin vaccine, the only vaccine available for TB, protects against disseminated and severe forms of the disease in young children, its safety in the HIV-infected population has been questioned. Multicentric trials are urgently required to help develop improved diagnostic strategies and formulate shorter, more effective, safe, and evidence-based regimens for treatment and prevention of drug-susceptible and drug-resistant TB.
结核病（TB）是全球儿童十大死因之一；然而，在大多数国家卫生规划中，儿童结核病的优先级较低，在这场疫情中被忽视。最近在成人结核病诊断方面的技术进步尚未在儿童中得到验证。同样，新药物的试验和标准一线和二线药物的儿科配方的开发也落后了。在人类免疫缺陷病毒（HIV）合并感染的儿童中，需要进一步研究开始高效抗逆转录病毒治疗的最佳时机以及与抗结核药物相互作用最小的药物组合。虽然卡介苗疫苗是唯一可用于结核病的疫苗，但它可以预防幼儿中播散性和严重形式的疾病，但在 HIV 感染者中的安全性受到了质疑。迫切需要进行多中心试验，以帮助制定改进的诊断策略，并制定更短、更有效、更安全和基于证据的方案，用于治疗和预防敏感和耐药结核病。
