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重新审视儿童结核病的预防治疗。

A relook at preventive therapy for tuberculosis in children.

机构信息

Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, Bangla Sahib Marg, New Delhi, 110001, India.

出版信息

Indian J Pediatr. 2011 Feb;78(2):205-10. doi: 10.1007/s12098-010-0257-0. Epub 2010 Oct 27.

Abstract

Preventive therapy for tuberculosis in children is an important strategy to control pediatric TB in addition to early diagnosis and treatment of infectious cases in the community. In low burden countries, it is an important tool for preventing TB at all ages as the opportunities for re-infection are few. In contrast in high burden countries, preventive therapy though effective in preventing occurrence of disease among infected, can not prevent re-infection--an event of fairly high occurrence in these settings. Children under 5 years of age or immuno-compromised children of any age who have the highest risk of developing infection and disease when exposed are the main focus for preventive therapy in high burden settings. A 6 months therapy with INH continues to be the preferred modality of preventive therapy as efforts are being made to identify a short course preventive therapy using Rifampicin and other drugs.

摘要

儿童结核病的预防治疗是控制儿童结核病的重要策略,除此之外,还需要对社区中具有传染性的病例进行早期诊断和治疗。在低负担国家,预防治疗是预防各年龄段结核病的重要工具,因为再次感染的机会很少。相比之下,在高负担国家,预防治疗虽然可以有效预防感染者发病,但不能预防再次感染——在这些环境中,再次感染的发生率相当高。5 岁以下儿童或任何年龄免疫功能低下的儿童,在接触后发生感染和疾病的风险最高,是高负担环境中预防治疗的主要重点。6 个月的异烟肼治疗仍然是预防治疗的首选方式,因为正在努力确定使用利福平及其他药物的短程预防治疗方案。

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