Nolan R J
Am J Public Health. 1986 Jan;76(1):26-30. doi: 10.2105/ajph.76.1.26.
New cases of tuberculosis in children continue to appear. A retrospective review of the medical records of a representative sample of such cases occurring from 1977 through 1981 was conducted to gain an understanding of why this preventable disease continues to occur in North Carolina children. Three per cent of cases were detected by routine screening; 17 per cent were diagnosed after the child's symptomatic presentation; and 80 per cent after contact screening. However, 14 per cent of cases detected by contact screening developed disease while receiving isoniazid prophylaxis for a positive tuberculin test; and 19 per cent of cases detected by contact screening developed disease while under surveillance, but not receiving isoniazid prophylaxis, as tuberculin negative contacts of known infectious cases. Adherence to accepted recommendations for prophylaxis should reduce the childhood tuberculosis case rate.
儿童结核病新病例仍在不断出现。我们对1977年至1981年期间此类病例的代表性样本的病历进行了回顾性研究，以了解为何这种可预防的疾病在北卡罗来纳州的儿童中持续出现。3%的病例通过常规筛查发现；17%在儿童出现症状后确诊；80%在接触者筛查后确诊。然而，在因结核菌素试验阳性而接受异烟肼预防性治疗的接触者筛查发现的病例中，有14%在接受预防性治疗期间发病；在作为已知感染病例的结核菌素阴性接触者接受监测但未接受异烟肼预防性治疗的接触者筛查发现的病例中，有19%发病。坚持接受预防性治疗的建议应可降低儿童结核病发病率。
