Department of Paediatrics and Child Health, Faculty of Health Sciences, Tygerberg Children's Hospital, Stellenbosch University, Tygerberg 7505, South Africa.
Infect Dis Clin North Am. 2010 Sep;24(3):727-49. doi: 10.1016/j.idc.2010.04.004.
Although awareness is growing, childhood tuberculosis (TB) remains a neglected disease in many resource-limited settings. In part this reflects operational difficulties, lack of visibility in official reports, as well as perceptions that children tend to develop mild disease, contribute little to disease transmission, and do not affect epidemic control. At an international level there is greater appreciation that children contribute significantly to the global TB disease burden and suffer severe TB-related morbidity and mortality, particularly in TB-endemic areas, where the disease often remains undiagnosed. However, this is not always the case at the national or local level and there remains an urgent need for feasible and implementable policies to guide clinical practice. Pediatric TB can be regarded as an emerging epidemic in areas where the adult epidemic remains out of control and Mycobacterium tuberculosis transmission is ongoing. This article reviews important concepts, challenges, and management principles related to childhood TB; it also summarizes the main priorities for future research.
尽管人们的认识在不断提高，但在许多资源有限的环境中，儿童结核病（TB）仍然是一种被忽视的疾病。这在一定程度上反映了操作上的困难、官方报告中缺乏可见性，以及人们认为儿童往往病情较轻、对疾病传播的贡献不大、不会影响疫情控制等观念。在国际层面，人们越来越认识到儿童对全球结核病负担有重大影响，他们会遭受严重的结核病相关发病率和死亡率，特别是在结核病流行地区，这些地区的疾病往往得不到诊断。然而，在国家或地方一级并非总是如此，仍然迫切需要可行和可执行的政策来指导临床实践。在成人结核病流行仍未得到控制且结核分枝杆菌传播仍在继续的地区，儿童结核病可被视为一种新出现的流行疾病。本文综述了与儿童结核病相关的重要概念、挑战和管理原则；还总结了未来研究的主要重点。
