Copenhagen University Hospital, Hvidovre.
Eur Respir J. 2014 Mar;43(3):863-71. doi: 10.1183/09031936.00059913. Epub 2013 Aug 29.
Paediatric tuberculosis (TB) is a key indicator for recent transmission and presents a reservoir for the disease. We describe trends in epidemiology, microbiological characteristics and treatment outcome in Denmark between 2000 and 2009. Data were retrieved from the national TB surveillance system and the International Reference Laboratory of Mycobacteriology. In total, 323 TB cases were reported in children aged <15 years, accounting for 7.6% of all notified cases in Denmark. The overall incidence rate of childhood TB declined from 4.1 per 100,000 to 1.9 per 100,000 in the study period. Immigrant children comprised 79.6% of all cases, with the highest incidence rate of 94.1 per 100,000 children in 2001. In contrast to immigrant children, the majority of Danish children were aged <5 years and had a known exposure to TB. Pulmonary TB was the commonest presentation. Only half of the cases were culture confirmed. We observed an overall decreasing trend in the child to adult notification ratio, but a slight increase in the ratio when calculated specifically for ethnic Danes. Childhood TB needs continuous attention with a special focus on risk groups. Emphasis on improving early TB case detection, contact tracing and further implementation of preventive treatment is necessary.
儿科结核病(TB)是近期传播的关键指标,也是疾病的储库。我们描述了 2000 年至 2009 年丹麦的流行病学、微生物学特征和治疗结果趋势。数据来自国家结核病监测系统和国际分枝杆菌参考实验室。共有 323 例年龄<15 岁的儿童结核病病例报告,占丹麦所有报告病例的 7.6%。在研究期间,儿童结核病的总发病率从每 100,000 人 4.1 例下降到每 100,000 人 1.9 例。所有病例中,移民儿童占 79.6%,2001 年发病率最高,为每 100,000 名儿童 94.1 例。与移民儿童不同,大多数丹麦儿童的年龄<5 岁,且已知接触过结核病。肺结核是最常见的表现形式。只有一半的病例经培养确诊。我们观察到儿童到成人的通报比例总体呈下降趋势,但当专门针对丹麦人计算时,该比例略有增加。儿童结核病需要持续关注,特别关注风险群体。必须强调提高早期结核病病例发现、接触者追踪以及进一步实施预防治疗的力度。