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发展中国家的儿童肺炎。

Childhood pneumonia in developing countries.

机构信息

Center for Global Health and Development, Boston University, Boston, MA, USA.

Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

Lancet Respir Med. 2013 Sep;1(7):574-84. doi: 10.1016/S2213-2600(13)70075-4. Epub 2013 Jun 18.

Abstract

Pneumonia is a widespread and common infectious lung disease that causes inflammation, which can lead to reduced oxygenation, shortness of breath, and death. An estimated nearly 1.2 million children younger than 5 years died in 2011 from pneumonia. Most of these deaths occured in developing countries where access to care is limited and interventions that have improved care in developed countries are scarce. Despite substantial increases in our understanding of the clinical syndrome of pneumonia and its aetiologies, its accurate diagnosis is challenging when clinical indicators are relied on, and improves only modestly with addition of laboratory, microbiological, or radiographical tests. Prevention programmes and treatment guidelines have led to impressive reductions in disease, but children remain at risk of misdiagnosis and inadequate treatment. Research to address challenges in the aetiological diagnosis of pneumonia and widespread implementation of treatment interventions beyond vaccines and antibiotics are necessary to mitigate the burden of pneumonia and improve child survival.

摘要

肺炎是一种广泛而常见的肺部传染病,可引起炎症,导致氧气供应减少、呼吸急促和死亡。据估计,2011 年,近 120 万 5 岁以下儿童死于肺炎。这些死亡大多发生在发展中国家,这些国家的医疗条件有限,而且发达国家改善护理的干预措施也很匮乏。尽管我们对肺炎的临床综合征及其病因有了实质性的了解,但当仅依赖临床指标时,其准确诊断仍具有挑战性,而通过实验室、微生物学或影像学检查的补充,也只能略有改善。预防规划和治疗指南使疾病的发病率显著下降,但儿童仍存在误诊和治疗不足的风险。需要开展研究来解决肺炎病因诊断方面的挑战,并广泛实施治疗干预措施,超越疫苗和抗生素,以减轻肺炎负担,提高儿童生存率。

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