Didilescu Cristian, Cioran Nicoleta, Chiotan Domnica, Popescu Gilda
Institutul de Pneumologie Marius Nosto - Progromul Noationalde Control al Tuberculozei, Bucureşti.
Pneumologia. 2013 Jan-Mar;62(1):10-4.
According to the World Health Organization and Stop TB Partnership, tuberculosis among children often remains undiagnosed, the main reported causes being lack of access to health services or because health professionals unrecognizing the signs and symptoms of tuberculosis in this age group. In Romania, consistent with TB endemic levels, the overall incidence progressively decreased from 142.2%ooo in 2002 to 82.8%ooo in 2011, incidence of TB in children 0-14 years dropped steadily from 47.2 %ooo (1784 cases) in the same "peak year"2002 to 23.6% ooo (766 cases) in 2011. The distribution of TB disease in children by counties shows variations between these, the explanations may be related both to differences in offer of the bacilli between different areas (prevalence of pulmonary patients smear and/or culture positive) and by deficiencies in the detection of cases and lack of rigor in diagnosis (variation in the incidence of TB in 0-14 years from 2.S%ooo in Sălaj county up to 53.2%ooo in Maramures county in 2011). The number of serious cases of TB in children (meningoencephalitis, miliary, cavitary) still maintains a constant high annual rate (65 cases in 2011), which demonstrates the severity of endemic TB in our country. Prompt assurance of TB diagnostic and also the accurate management of TB treatment constitute the guarantee of the decrease of this disease, goal applies to all age groups.
根据世界卫生组织和终止结核病伙伴关系的数据,儿童结核病往往未被诊断出来,主要原因是难以获得医疗服务,或者卫生专业人员未识别出该年龄组结核病的体征和症状。在罗马尼亚,与结核病流行水平一致,总体发病率从2002年的142.2/10万逐渐下降到2011年的82.8/10万,0至14岁儿童的结核病发病率在同一“高峰年”2002年的47.2/10万(1784例)稳步下降到2011年的23.6/10万(766例)。按县划分的儿童结核病分布情况显示出各县之间存在差异,其原因可能既与不同地区结核杆菌供应的差异(肺结核患者涂片和/或培养阳性的患病率)有关,也与病例检测不足和诊断不严格有关(2011年0至14岁结核病发病率在萨拉伊县为2.5/10万,在马拉穆列什县高达53.2/10万)。儿童严重结核病病例(结核性脑膜炎、粟粒性、空洞性)的数量仍然保持每年较高的恒定水平(2011年为65例),这表明我国结核病流行的严重性。及时确保结核病诊断以及准确管理结核病治疗是减少这种疾病的保证,这一目标适用于所有年龄组。