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中国山东一家结核病转诊医院儿童结核病发病形式的流行病学趋势。

Epidemiological Trends in the Form of Childhood Tuberculosis in a Referral Tuberculosis Hospital in Shandong, China.

机构信息

Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

Department of Lab Medicine, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

出版信息

Biomed Res Int. 2020 Aug 8;2020:6142567. doi: 10.1155/2020/6142567. eCollection 2020.

Abstract

BACKGROUND

In China, the prevalence of tuberculosis (TB) diseases and epidemiological trends in the TB forms among children are still unclear; a retrospective study was conducted aiming to assess it.

METHODS

Between January 2007 and September 2020, 1577 consecutive childhood TB patients (aged ≤ 15 years) were included in the study. Data, including demographic information and underlying diseases, were collected from medical records. Then, patients were categorized and reported according to the anatomical site of TB disease. To analyze the epidemiological trends in the proportion of each form of TB disease, a linear-by-linear association was used, and a value of <0.05 was considered to indicate that a significant change had occurred in the proportion of TB disease over the studied period.

RESULTS

During the fourteen-year study period, a total of 1577 children patients were enrolled, including 954 boys (60.5%) and 623 girls (39.5%), with a mean age of 9.26 ± 5.18 years. Among the studied patients, 810 (51.4%) patients have pulmonary TB, 1137 (72.1%) have extrapulmonary TB, 372 (23.6%) have both conditions, and another 765 (48.5%) extrapulmonary cases presented in isolated form. Pleural TB (29.0%) and tuberculous lymphadenitis (23.7%) were the most frequent two forms of childhood TB. In addition, during the past decade, the proportions of pulmonary TB, pleural TB, and tuberculous lymphadenitis showed an increasing trend (all < 0.05). However, no significant trends in the proportions of other forms of TB disease, such as extrapulmonary TB ( > 0.05), tuberculous meningitis ( > 0.05), endobronchial TB ( > 0.05), and disseminated TB ( > 0.05), were found.

CONCLUSION

Our findings suggest that childhood TB is facing new challenges, and the policy should be adjusted timely to fit the real situation.

摘要

背景

在中国,结核病(TB)的流行情况以及儿童中 TB 形式的流行病学趋势尚不清楚;因此进行了一项回顾性研究以评估这些情况。

方法

2007 年 1 月至 2020 年 9 月,共纳入 1577 例连续的儿童 TB 患者(年龄≤15 岁)。从病历中收集数据,包括人口统计学信息和基础疾病。然后,根据 TB 疾病的解剖部位对患者进行分类和报告。为了分析每种 TB 疾病形式比例的流行病学趋势,使用了线性关联检验,并且 值<0.05 被认为是研究期间 TB 疾病比例发生了显著变化。

结果

在 14 年的研究期间,共纳入了 1577 例儿童患者,包括 954 例男孩(60.5%)和 623 例女孩(39.5%),平均年龄为 9.26±5.18 岁。在研究患者中,810 例(51.4%)患者患有肺结核,1137 例(72.1%)患有肺外 TB,372 例(23.6%)同时患有两种疾病,另外 765 例(48.5%)肺外病例呈孤立形式。胸腔 TB(29.0%)和结核性淋巴结炎(23.7%)是儿童 TB 最常见的两种形式。此外,在过去十年中,肺结核、胸腔 TB 和结核性淋巴结炎的比例呈上升趋势(均<0.05)。然而,其他形式的 TB 疾病,如肺外 TB(>0.05)、结核性脑膜炎(>0.05)、支气管内 TB(>0.05)和播散性 TB(>0.05)的比例并没有明显的趋势变化。

结论

我们的研究结果表明,儿童 TB 面临新的挑战,应及时调整政策以适应实际情况。

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