Colgan Katrina, Anderson Jennifer, Maycock Alanna, Britton Philip N, Mackenzie Merran, Isaacs David, Gunasekera Hasantha
Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2019 Jul;55(7):826-832. doi: 10.1111/jpc.14304. Epub 2018 Nov 22.
(i) To determine the prevalence of latent tuberculosis infection (LTBI) and characteristics associated with LTBI in children attending a paediatric refugee clinic and (ii) to determine whether current New South Wales (NSW) Health screening practices could miss LTBI cases.
This was a retrospective analysis of tuberculosis (TB) screening data from refugee and asylum seeker children who attended a refugee clinic in a tertiary children's hospital during 2014 and 2015. We determined associations between LTBI and child characteristics at 5% significance levels.
Of 358 children attending the clinic, 235 children (66%) received interferon-gamma release assay (IGRA) testing, of whom 28 (11.9%) had positive results. Of the 28 with positive IGRAs, 12 (42.9%) would have been missed using NSW Health screening guidelines: two because they were younger than 2 years old, one who was born in Australia and 10 because they were not born in high TB incidence countries. IGRA results were not significantly associated with any of the child characteristics examined, including age, gender, travel through transit countries, boat versus plane arrival into Australia, whether the child had been in a detention centre or TB incidence in the source country.
We identified 12 children with LTBI who would have been missed using current NSW Health Department screening practices. These children are at risk of progression to active disease, particularly the two aged younger than 2 years old. We recommend universal screening.
（i）确定在一家儿科难民诊所就诊的儿童中潜伏性结核感染（LTBI）的患病率及其相关特征；（ii）确定新南威尔士州（NSW）目前的健康筛查方法是否会漏诊LTBI病例。
这是一项对2014年和2015年在一家三级儿童医院的难民诊所就诊的难民和寻求庇护儿童的结核病（TB）筛查数据的回顾性分析。我们在5%的显著性水平上确定了LTBI与儿童特征之间的关联。
在358名就诊儿童中，235名儿童（66%）接受了干扰素-γ释放试验（IGRA）检测，其中28名（11.9%）结果呈阳性。在这28名IGRA检测呈阳性的儿童中，按照新南威尔士州健康筛查指南，有12名（42.9%）会被漏诊：2名是因为年龄小于2岁，1名是在澳大利亚出生，10名是因为并非出生在结核病高发病率国家。IGRA结果与所检查的任何儿童特征均无显著关联，这些特征包括年龄、性别、是否途经中转国家、乘船还是乘飞机抵达澳大利亚、儿童是否曾被拘留在拘留中心或来源国的结核病发病率。
我们发现有12名LTBI儿童会被目前新南威尔士州卫生部的筛查方法漏诊。这些儿童有发展为活动性疾病的风险，尤其是两名年龄小于2岁的儿童。我们建议进行普遍筛查。
