Al Yazidi Laila S, Marais Ben J, Wickens Meredith, Palasanthiran Pamela, Isaacs David, Outhred Alexander, McMullan Brendan, Britton Philip N
Immunology and Infectious Diseases Department, Sydney Children's Hospital, NSW, Australia; School of Women's and Children's Health, UNSW Sydney, Australia; Infectious Diseases and Microbiology Department, The Children's Hospital at Westmead, Sydney, NSW, Australia,
Infectious Diseases and Microbiology Department, The Children's Hospital at Westmead, Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia.
Public Health Res Pract. 2019 Jul 31;29(2):282318076. doi: 10.17061/phrp28231807.
Sydney has a large and highly mobile immigrant community. The pattern of paediatric tuberculosis (TB) disease in this highly cosmopolitan city is not well documented.
We reviewed data on all children notified with TB in New South Wales (NSW), Australia, from January 2014 to December 2015, complemented by an expanded dataset for children managed within the Sydney Children's Hospitals Network (SCHN).
Over the 2-year study period, 921 TB cases were identified in NSW, including 26 (2.8%) children younger than 15 years of age. Of 23 children and adolescents treated for TB in the SCHN, 21 (91.3%) had a history of recent immigration from, or travel to, a country with high TB incidence, and 7 (30.4%) reported contact with an infectious TB case in Australia. Fourteen (60.9%) children had microbiologically confirmed TB; of these, 5 (21.7%) had acid-fast bacilli on microscopy, 8 (34.8%) were positive by polymerase chain reaction and 11 (47.8%) were positive by culture. All Mycobacterium tuberculosis isolates were susceptible to first-line drugs. Ten (43.5%) cases were not vaccinated with bacille Calmette-Guérin (BCG), including all cases with severe disease: 2 with disseminated (miliary) TB and 3 with tuberculous meningitis.
Our findings emphasise the need for improved TB prevention and surveillance in children at high risk of exposure, particularly young children travelling to areas of high TB incidence.
悉尼有大量流动性很强的移民群体。在这个高度国际化的城市中，儿童结核病的发病模式尚无充分记录。
我们回顾了2014年1月至2015年12月在澳大利亚新南威尔士州（NSW）报告的所有儿童结核病数据，并辅以悉尼儿童医院网络（SCHN）管理的儿童扩展数据集。
在为期2年的研究期间，新南威尔士州共确诊921例结核病病例，其中包括26例（2.8%）15岁以下儿童。在悉尼儿童医院网络接受结核病治疗的23名儿童和青少年中，21名（91.3%）有近期从结核病高发国家移民或前往这些国家的历史，7名（30.4%）报告在澳大利亚接触过传染性结核病病例。14名（60.9%）儿童经微生物学确诊患有结核病；其中，5名（21.7%）在显微镜检查中发现抗酸杆菌，8名（34.8%）通过聚合酶链反应呈阳性，11名（47.8%）通过培养呈阳性。所有结核分枝杆菌分离株对一线药物敏感。10例（43.5%）病例未接种卡介苗（BCG），包括所有重症病例：2例播散性（粟粒性）结核病和3例结核性脑膜炎。
我们的研究结果强调，需要加强对高暴露风险儿童，特别是前往结核病高发地区的幼儿的结核病预防和监测。
