Uhari M, Linna O
Eur J Respir Dis. 1982 Nov;63(6):579-83.
In a 1-year prospective study 83 children, who had been in close contact with 52 adults who had tuberculosis, were examined. Thirty-six of the index cases had culture positive tuberculosis and 16 of these had smear positive tuberculosis. All the children had been BCG-vaccinated at birth. Forty-one (49%) of the children were PPD negative on examination with the Mantoux test. Of these 83 children, one 14-year-old boy was diagnosed as having primary tuberculosis and was treated. Twenty-one children received INH therapy, 12 because of their age (under 2 years of age or at puberty), nine because of a strong positive reaction to the first Mantoux test or because of the conversion of a negative test result to positive during the follow-up period. Seven of the latter nine children had been in contact with persons whose disease was culture- and smear-positive. It is concluded that as the frequency of tuberculosis declines, the practice of examining all children who have been in close contact with tuberculous adults is possible. The children who have been in contact with smear-positive index cases are at special risk of contracting tuberculosis.
在一项为期1年的前瞻性研究中，对83名与52名患结核病的成年人有过密切接触的儿童进行了检查。其中36名索引病例的结核培养呈阳性，其中16名痰涂片呈阳性。所有儿童出生时均接种过卡介苗。在进行结核菌素试验检查时，41名（49%）儿童的结核菌素试验呈阴性。在这83名儿童中，一名14岁男孩被诊断为原发性结核病并接受了治疗。21名儿童接受了异烟肼治疗，12名是因为年龄（2岁以下或青春期），9名是因为对首次结核菌素试验有强阳性反应或在随访期间结核菌素试验结果由阴性转为阳性。后9名儿童中有7名与痰培养和涂片均呈阳性的患者有过接触。得出的结论是，随着结核病发病率的下降，对所有与患结核病的成年人有过密切接触的儿童进行检查是可行的。与痰涂片呈阳性的索引病例有过接触的儿童感染结核病的风险特别高。
