Global Health Directorate, Indus Health Network, Interactive Research and Development, Pakistan, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
Global Health Directorate, Indus Health Network, Interactive Research and Development, Pakistan.
Int J Tuberc Lung Dis. 2018 Aug 1;22(8):851-857. doi: 10.5588/ijtld.17.0736.
Many children with tuberculosis (TB) remain undiagnosed due to the absence of services, lack of child-friendly diagnostics and underappreciation of TB as a common cause of childhood illness.
To show the impact of systematic verbal screening and contact tracing with appropriate management services on TB case finding in pediatric populations.
Between October 2014 and March 2016, children were verbally screened at the pediatric out-patient departments of four public hospitals in Jamshoro District, Pakistan. Children with symptoms or risk of TB were referred for clinical evaluation and free chest X-ray and bacteriological tests. Children with TB were started on treatment and their care givers asked to bring household members to the hospital for screening.
Over 105 000 children were verbally screened and 5880 presumptive childhood TB patients were identified; 1417 children (prevalence 1.3%) were diagnosed with TB; 43% were female. The median age was 5 years; 82% had pulmonary TB. An additional 390 children with TB were diagnosed through contact tracing. These activities resulted in a three-fold increase in pediatric TB case notifications.
Systematic verbal screening with clinical evaluation and free diagnostics can identify children with TB who may otherwise be missed in rural health settings.
由于缺乏服务、缺乏适合儿童的诊断方法以及对结核病作为儿童常见疾病的认识不足，许多儿童结核病（TB）患者未得到诊断。
展示系统的口头筛查和接触者追踪，并结合适当的管理服务，对儿科人群中结核病发现的影响。
2014 年 10 月至 2016 年 3 月期间，在巴基斯坦贾姆肖罗地区的四家公立医院的儿科门诊对儿童进行了口头筛查。有症状或有结核病风险的儿童被转诊进行临床评估和免费胸部 X 光和细菌学检查。结核病患儿开始接受治疗，并要求其照顾者带家庭成员到医院进行筛查。
超过 105000 名儿童接受了口头筛查，发现了 5880 例疑似儿童结核病患者；1417 名儿童（患病率 1.3%）被诊断患有结核病；43%为女性。中位数年龄为 5 岁；82%患有肺结核。通过接触者追踪又诊断出 390 名患有结核病的儿童。这些活动使儿科结核病病例报告数量增加了三倍。
系统的口头筛查结合临床评估和免费诊断可以发现可能在农村卫生环境中被遗漏的结核病患儿。
