Ma Hee Won, Lee Hee Soo, Ahn Ji Young
College of Medicine, Yeungnam University, Daegu 42415, Korea.
Department of Pediatrics, College of Medicine, Yeungnam University, Daegu 42415, Korea.
Children (Basel). 2022 Oct 17;9(10):1567. doi: 10.3390/children9101567.
The incidence of tuberculosis remains high in South Korea; the management of latent tuberculosis infection (LTBI) has become the prime target for reducing the infection rate. The management of pediatric LTBI is especially crucial because children can serve as a long-term source of infection upon developing active tuberculosis. Therefore, it is important to assess pediatric LTBI using contact investigation and follow-up. We conducted a retrospective study on children aged between 0 and 18 years who visited our hospital for tuberculosis contact screening from February 2012 to February 2021. Tuberculosis index cases and their clinical characteristics were also reviewed retrospectively. A total of 350 children were investigated, and 68 of 247 (27.5%) were diagnosed with LTBI. The rate of LTBI (r = 7.98, p < 0.001) and the risk of loss to follow-up (r = 27.038, p < 0.001) were higher in cases with close household contact. Sputum (r = 10.992, p < 0.001) and positive acid-fast bacillus (AFB) stain (r = 4.458, p = 0.001) in tuberculosis index cases were related to the diagnosis of LTBI in pediatric contacts. Active management is needed for tuberculosis screening in pediatric contacts, especially when the contacts are older and the index case is within the family, and when the index case has sputum and has tested positive for AFB smear.
韩国的结核病发病率仍然很高；潜伏性结核感染（LTBI）的管理已成为降低感染率的主要目标。儿童LTBI的管理尤为关键，因为儿童一旦发展为活动性结核病，就可能成为长期感染源。因此，通过接触者调查和随访来评估儿童LTBI很重要。我们对2012年2月至2021年2月期间因结核病接触筛查到我院就诊的0至18岁儿童进行了一项回顾性研究。对结核病索引病例及其临床特征也进行了回顾性分析。共调查了350名儿童，247名中的68名（27.5%）被诊断为LTBI。家庭密切接触者的LTBI发生率（r = 7.98，p < 0.001）和失访风险（r = 27.038，p < 0.001）更高。结核病索引病例的痰液（r = 10.992，p < 0.001）和抗酸杆菌（AFB）染色阳性（r = 4.458，p = 0.001）与儿童接触者的LTBI诊断有关。对于儿童接触者的结核病筛查需要积极管理，尤其是当接触者年龄较大且索引病例在家庭中，以及索引病例有痰液且AFB涂片检测呈阳性时。
