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[阿比让(科特迪瓦)感染肺结核杆菌患者接触儿童的异烟肼(INH)初级预防现状]

[Current situation of primary prophylaxis with isoniazid (INH) in children who are contacts of patients with bacillary pulmonary tuberculosis in Abidjan (Cote d'Ivoire)].

作者信息

Koné Z, Coulibaly G, Daix A T J, Bakayoko A S, Samaké K, Kouassi D P, Domoua K M S

机构信息

Service de pneumophtisiologie, CHU Treichville, BP V 03 Abidjan, Cote d'Ivoire.

Service de pneumophtisiologie, CHU Treichville, BP V 03 Abidjan, Cote d'Ivoire.

出版信息

Rev Pneumol Clin. 2016 Dec;72(6):340-345. doi: 10.1016/j.pneumo.2016.08.003. Epub 2016 Oct 21.

Abstract

INTRODUCTION

The National tuberculosis program (NTP) in Ivory Coast recommends that children under 5 years living in a family environment with contagious tuberculosis patients, should receive Prophylactic treatment with INH (PTI), whatever the result of the tuberculin skin test (positive or negative) and their BCG status (vaccinated or not), at a dose of 5mg/kg/day for 6 months. We conducted this study to check the implementation of this recommendation in three support services of tuberculosis in Abidjan, the economic capital.

MATERIAL AND METHOD

We conducted a multicenter, cross-sectional and descriptive study over 3 years (2011-2013), on consented patients, adolescents and adults aged at least 15 years, with a first episode of infectious pulmonary tuberculosis, in order to look for information on the INH prophylaxis in children under 5 years living under the same roof. We made patients interviews during their visit for bacteriological sputum controls at the second month of TB treatment.

RESULTS

Of a total of 412 patients (53% males and 47% females) with a mean age of 34.5 years and with a low level of instruction (66.5%), we noticed 639 children under 5 years living under the same roof with them. Information on the screening of contact children was given to 71% of interviewed patients (291/412). Of the 339 children examined among 639 contacts, 234 (69%) had received only an intradermoreaction (IDR) and PTI was finally administered to 64% of them (217/339).

CONCLUSION

High proportion of contact children under 5 not examined is a major concern for the NTP and a missed opportunity to prevent additional cases of tuberculosis among children.

摘要

引言

科特迪瓦的国家结核病防治项目(NTP)建议,与传染性肺结核患者生活在同一家庭环境中的5岁以下儿童,无论结核菌素皮肤试验结果(阳性或阴性)以及卡介苗接种状态(接种或未接种)如何,均应接受异烟肼预防性治疗(PTI),剂量为5毫克/千克/天,疗程6个月。我们开展这项研究,以核查在经济首都阿比让的三个结核病支持服务机构中该建议的实施情况。

材料与方法

我们在2011年至2013年的3年时间里,对年龄至少15岁、首次发作传染性肺结核且同意参与研究的患者、青少年及成年人进行了一项多中心、横断面描述性研究,旨在获取与居住在同一屋檐下的5岁以下儿童接受异烟肼预防治疗相关的信息。在患者接受结核病治疗第二个月进行痰菌检查的就诊期间,我们对他们进行了访谈。

结果

在总共412例患者(男性占53%,女性占47%)中,平均年龄为34.5岁,文化程度较低(66.5%),我们注意到有639名5岁以下儿童与他们生活在同一屋檐下。71%(291/412)的受访患者提供了有关接触儿童筛查的信息。在639名接触儿童中,有339名接受了检查,其中234名(69%)仅接受了皮内反应(IDR)检查,最终64%(217/339)的儿童接受了PTI治疗。

结论

未接受检查的5岁以下接触儿童比例较高,这是国家结核病防治项目的一个主要担忧,也是预防儿童新增结核病病例的一个错失的机会。

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