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过去35年捷克共和国儿童肺外结核病发病率的趋势。

Trends in incidence of extrapulmonary tuberculosis in children in the Czech Republic in the past 35 years.

作者信息

Doležalová Karolína, Kika Vojtěch, Göpfertová Dana, Wallenfels Jiří

机构信息

Clinic of Paediatrics, First Faculty of Medicine, Charles University in Prague and Thomayer University Hospital, Prague, Czech Republic.

Department of Mathematics and Leuven Statistics Research Centre, KU Leuven, Leuven, Belgium.

出版信息

Cent Eur J Public Health. 2022 Dec;30(4):207-212. doi: 10.21101/cejph.a7499.

Abstract

OBJECTIVE

Extrapulmonary tuberculosis (EPTB) in children globally represents a proportion of all cases of tuberculosis, reaching 20% according to published reports. Children are at a higher risk for disseminated TB and extrapulmonary forms. The most prevalent clinical presentations of EPTB in children worldwide are peripheral lymphadenitis and osteoarticular TB. Peritoneal, urogenital, or meningeal tuberculosis is less frequent, and their diagnosis is often difficult. The aim of the study was the determination of EPTB incidence in children in a low-prevalence region over 35 years.

METHODS

Descriptive retrospective study of the incidence of EPTB in children and adolescents (aged 0-18 years) in the Czech Republic in the years 1987-2021 as reported in the tuberculosis register.

RESULTS

Total amount of EPTB cases was 95. The most prevalent form was extrathoracic lymph node TB. The median age was 10 years. Most patients (84%) were Czechs. None of them died. The ratio of pulmonary and extrapulmonary TB was 79.8% to 20.2%.

CONCLUSION

The low incidence of EPTB in Czech children is congruent with a low incidence of TB in the Czech Republic. Our study confirms that the most frequent form of EPTB is peripheral lymph node TB. Our study did not prove a significant change in the trend of EPTB after the cessation of the mandatory Bacillus Calmette-Guerin (BCG) vaccination programme.

摘要

目的

全球儿童肺外结核病(EPTB)占所有结核病病例的一定比例,根据已发表的报告,这一比例达到20%。儿童发生播散性结核病和肺外形式的风险更高。全球儿童EPTB最常见的临床表现是外周淋巴结炎和骨关节结核。腹膜、泌尿生殖系统或脑膜结核较少见,其诊断往往困难。本研究的目的是确定一个低发病率地区35年来儿童EPTB的发病率。

方法

对捷克共和国1987 - 2021年结核病登记册中报告的儿童和青少年(0 - 18岁)EPTB发病率进行描述性回顾性研究。

结果

EPTB病例总数为95例。最常见的形式是胸外淋巴结结核。中位年龄为10岁。大多数患者(84%)为捷克人。他们均无死亡。肺结核与肺外结核的比例为79.8%至20.2%。

结论

捷克儿童EPTB发病率低与捷克共和国结核病低发病率一致。我们的研究证实,EPTB最常见的形式是外周淋巴结结核。我们的研究未证明在强制性卡介苗(BCG)接种计划停止后EPTB趋势有显著变化。

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