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中国西南地区儿童结核病患者的临床特征、常见部位及地理分布

Clinical characteristic, common sites, and geographical distribution of pediatric tuberculosis patients in Southwest China.

作者信息

Wang Dong-Mei, Wang Chuan, An Qi, Yang Qing, Liao Yi

机构信息

Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China.

Department of Clinical Laboratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Front Pediatr. 2024 Mar 18;12:1327648. doi: 10.3389/fped.2024.1327648. eCollection 2024.

Abstract

BACKGROUND

The data report of a large sample, dynamic epidemiology, and characteristic analysis of pediatric tuberculosis (TB) in Southwest China is not clear. Herein, we conducted descriptive dynamic epidemiology, characteristic analysis and geographical distribution study of pediatric TB inpatients in Southwest China for more than 20 years.

METHODS

Patients with pediatric TB were recruited from October 2002 to September 2022 in Southwest of China based on etiology or clinical confirmation. Extract hospitalization medical record information for each patient. The geographical distribution chart of cases is used to display the trend of case flow segmented every 5 years.

RESULTS

Among 3,024 pediatric TB patients with an average age of 9.11 ± 4.39, 17.49% (529) had pulmonary tuberculosis (PTB), 9.06% (274) had extrapulmonary tuberculosis (EPTB), and 73.45% (2,221) had combined TB. The most common form of EPTB is disseminated TB (28.98%), followed by TB lymphadenitis (20.56%), pleural TB (19.72%), and TB meningitis (19.68%). Children aged 0-4 years had a high risk of TB meningitis and a severe symptoms, while children in the elderly age group had a high risk of pleural TB. In the past 20 years, hospitalized TB pediatric cases mainly came from Sichuan, Tibet, Qinghai, Yunnan and other places. The number of patients from ethnic minorities, especially Tibetans, showed an upward trend on a yearly basis ( = 401.43,  < 0.001).

CONCLUSIONS

Public health investment and effective management in pediatric TB should be further strengthened.

摘要

背景

中国西南地区儿童结核病(TB)的大样本数据报告、动态流行病学及特征分析尚不清楚。在此,我们对中国西南地区20多年来儿童结核病住院患者进行了描述性动态流行病学、特征分析及地理分布研究。

方法

2002年10月至2022年9月在中国西南部,根据病因或临床确诊招募儿童结核病患者。提取每位患者的住院病历信息。病例地理分布图用于展示每5年分段的病例流动趋势。

结果

在3024例平均年龄为9.11±4.39岁的儿童结核病患者中,17.49%(529例)患有肺结核(PTB),9.06%(274例)患有肺外结核(EPTB),73.45%(2221例)患有合并结核病。EPTB最常见的形式是播散性结核病(28.98%),其次是结核性淋巴结炎(20.56%)、结核性胸膜炎(19.72%)和结核性脑膜炎(19.68%)。0至4岁儿童患结核性脑膜炎的风险高且症状严重,而老年组儿童患结核性胸膜炎的风险高。在过去20年中,住院的儿童结核病病例主要来自四川、西藏、青海、云南等地。少数民族患者数量,尤其是藏族患者数量呈逐年上升趋势(χ²=401.43,P<0.001)。

结论

应进一步加强儿童结核病的公共卫生投入和有效管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b3e/10982491/5e0c3cbea798/fped-12-1327648-g001.jpg

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