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儿童(五岁以下)家庭接触新结核病例的结核感染流行率及其与发育迟缓的关系。

Prevalence of tuberculosis infection and its relationship to stunting in children (under five years) household contact with new tuberculosis cases.

机构信息

Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia; Department of Public Health, Universitas Islam Negeri Alauddin Makassar, Indonesia.

Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia.

出版信息

Indian J Tuberc. 2021 Jul;68(3):350-355. doi: 10.1016/j.ijtb.2020.10.011. Epub 2020 Nov 4.

Abstract

BACKGROUND

Children who inhabit the same house with tuberculosis (TB) patients are at high risk for infection and illness with TB. Nutritional status (stunting) in children is related to the child's ability to withstand MTB (Mycobacterium Tuberculosis). This study aims to estimated the prevalence of tuberculosis infection and its relationship to stunting in children (under five years) with household contact (HHC) with new TB cases.

METHODS

A cross-sectional design was implemented. Conducted in July 2018-April 2019 at 13 Public Health Center in Makassar City. The sample size was calculated using one sample situation-about precision formula. Samples were children under five who had contact with new diagnosed TB cases. Tuberculosis infection was measured by TST (tuberculin skin test). Logistic regression with causal model to examine TB infection relationship with stunting and covariate variable, analyzed using Stata/MP 13.0 software.

RESULTS

One hundred twenty-six (126) eligible children. Prevalence of tuberculosis infection was 38.10%. Frequency of stunted was 31 children (24.60%). Stunted nutritional status (aPR): 2.36, 95% CI 1.60-3.44), boys (aPR: 1.47, 95% CI 0.96-2.25), not getting BCG immunization (aPR: 1.58, 95%) CI 0.89-2.82), and high contact intensity (aPR: 2.62, 95% CI 1.10-6.22) best predicted the tuberculosis infection in children with TB case household contacts with a model contribution of 64%.

CONCLUSION

Stunted nutritional status (moderate and severe), boys, not getting BCG immunization, and high contact intensity are the determinants of TB infection transmission in children HHC with TB. Children under five years of age who have close contact with TB cases should be targeted for priority interventions to prevent the transmission of TB infection and progressing to TB cases.

摘要

背景

与肺结核(TB)患者居住在同一房屋中的儿童感染和患结核病的风险很高。儿童的营养状况(发育迟缓)与儿童对 MTB(结核分枝杆菌)的抵抗力有关。本研究旨在估计与新 TB 病例有家庭接触(HHC)的儿童(五岁以下)的结核感染率及其与发育迟缓的关系。

方法

采用横断面设计。于 2018 年 7 月至 2019 年 4 月在马卡萨市 13 个公共卫生中心进行。使用一个样本情况-关于精度公式计算样本量。样本为与新诊断的 TB 病例有接触的五岁以下儿童。结核感染通过 TST(结核菌素皮肤试验)测量。使用 Stata/MP 13.0 软件对因果模型进行逻辑回归分析,以检查结核感染与发育迟缓的关系和协变量变量。

结果

有 126 名符合条件的儿童。结核感染的患病率为 38.10%。发育迟缓的频率为 31 名儿童(24.60%)。营养不良发育迟缓(aPR):2.36,95%CI 1.60-3.44),男孩(aPR:1.47,95%CI 0.96-2.25),未接种卡介苗(aPR:1.58,95%CI 0.89-2.82),以及高接触强度(aPR:2.62,95%CI 1.10-6.22),最佳预测结核病感染的儿童与家庭接触的结核病病例,模型贡献度为 64%。

结论

营养不良发育迟缓(中度和重度)、男孩、未接种卡介苗和高接触强度是儿童与结核病病例有家庭接触的结核感染传播的决定因素。与结核病病例密切接触的五岁以下儿童应成为优先干预目标,以防止结核感染传播和发展为结核病病例。

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