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儿科结核病和耐多药结核病的发病率及治疗选择:系统评价。

The incidence of TB and MDR-TB in pediatrics and therapeutic options: a systematic review.

机构信息

Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Clinical Pharmacy Services Unit, Directorate of Pharmacy, Ho Teaching Hospital, Ho, Ghana.

出版信息

Syst Rev. 2022 Aug 4;11(1):157. doi: 10.1186/s13643-022-02023-1.

Abstract

BACKGROUND

Tuberculosis (TB) is considered one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. Multidrug-resistant (MDR) TB can affect people of all age groups, including children (aged 0-15 years). However, very little is known about the extent of this problem in children. This systematic review aims to investigate the incidence of TB and drug-resistant (DR) TB among the pediatric population. It also reviews the therapeutic options available to treat the condition.

METHODS

A comprehensive search for all relevant evidence was conducted. The following databases were searched: MEDLINE, CINAHL, and Web of Science. The searched time frame was limited from January 1990 to December 2020 with a focus on the incidence of TB and MDR-TB among pediatrics and the therapeutic options available.

RESULTS

A total of 537 articles were obtained via the selected databases. After title and abstract screening, 418 articles were excluded leaving 119 articles. Full-text screening was conducted on 119 articles, excluding a further 110 articles. Thus, 9 articles were subject to quality assessment and included in this review. The 9 articles represented the age group of 0-15 years and included both males and females. All studies included were of retrospective study design.

DISCUSSION

The included studies mentioned a moderate increase in TB cases among pediatrics exacerbated by malnutrition, lack of bacille Calmette-Guérin (BCG) vaccination, and human immunodeficiency virus (HIV) coinfection. MDR-TB prevalence was especially high in South Africa. Drug therapy for both TB and MDR-TB yielded favorable outcomes among pediatrics. However, one of the biggest challenges with drug therapy includes the dosage forms available.

SYSTEMATIC REVIEW REGISTRATION

DOI: 10.17605/OSF.IO/G34NF.

摘要

背景

结核病(TB)被认为是全球十大死因之一,也是单一传染病病原体导致的主要死因。耐多药(MDR)结核病可影响所有年龄段的人群,包括儿童(0-15 岁)。然而,人们对儿童中这一问题的严重程度知之甚少。本系统评价旨在调查儿科人群中结核病和耐药结核病(DR-TB)的发病率,并回顾治疗该病的可用治疗选择。

方法

对所有相关证据进行了全面检索。检索了 MEDLINE、CINAHL 和 Web of Science 这三个数据库。检索时间范围限定为 1990 年 1 月至 2020 年 12 月,重点关注儿科结核病和 MDR-TB 的发病率以及可用的治疗选择。

结果

通过选定的数据库共获得了 537 篇文章。经过标题和摘要筛选后,排除了 418 篇文章,剩下 119 篇。对这 119 篇文章进行了全文筛选,又排除了 110 篇。因此,有 9 篇文章进行了质量评估并纳入本综述。这 9 篇文章代表了 0-15 岁的年龄组,包括男性和女性。所有纳入的研究均为回顾性研究设计。

讨论

纳入的研究提到,由于营养不良、缺乏卡介苗(BCG)接种和人类免疫缺陷病毒(HIV)合并感染,儿科结核病病例有所增加,情况有所恶化。南非的 MDR-TB 患病率尤其高。结核病和 MDR-TB 的药物治疗在儿科人群中均取得了良好的效果。然而,药物治疗面临的最大挑战之一是可用的剂型。

系统评价注册

DOI:10.17605/OSF.IO/G34NF。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a9a/9354367/a06b52e420c2/13643_2022_2023_Fig1_HTML.jpg

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