de March-Ayuela P
Dispensario de Enfermedades del Torax, Barcelona, Spain.
Tuber Lung Dis. 1994 Dec;75(6):423-8. doi: 10.1016/0962-8479(94)90115-5.
All the paediatric hospitals in the province of Barcelona.
To examine the trend in the incidence of tuberculous meningitis (TM) in children aged 0-4 years and its correlation with the annual risk of tuberculous infection.
Survey conducted between 1975 and 1991.
157 cases of TM in children aged 0-4 years were diagnosed between 1975 and 1991. A constant decrease during the prospective period is observed from 21 cases of TM in 1977 to only 2 cases in 1991 with an annual decrease of 5.5%, which is smaller than the 8% annual decrease of the annual risk of tuberculous infection. A close correlation between the observed incidence of TM and the average annual risk of infection to which children in the same area were exposed r = 0.9156 (P < 0.0001) is verified. Moreover, this correlation gets even closer when considering the annual risk of infection as a percentage of the TM incidence, since a stable correlation of about 1% (0.89-1.39%) is demonstrated. Nevertheless, the incidence and the number of observed cases of TM is twice that expected if one refers to the Table that calculates meningitis cases by means of the annual risk of infection. We observed one case of TM among 218-384 infected children, i.e. a risk of developing TM of 0.19-0.26%, higher than that found in the countries with the most favourable tuberculosis situations. The sharp decrease of TM coincides with the suppression of BCG-vaccination in Barcelona, which suggests that it has not substantially changed the decrease of the risk of developing TM in children under 5 years of age. The decrease in the annual risk of infection, and consequently TM, is essentially due to the improvement of treatment in adults.
It is confirmed that the incidence of TM in children under 5 years represents 1% of the annual risk of infection. The TM incidence thus permits the determination of the annual risk of infection when the conditions to calculate it directly do not exist.
巴塞罗那省的所有儿科医院。
调查0至4岁儿童结核性脑膜炎（TM）的发病率趋势及其与结核感染年风险的相关性。
1975年至1991年期间进行的调查。
1975年至1991年期间，共诊断出157例0至4岁儿童的TM病例。在研究期间观察到TM病例数持续下降，从1977年的21例降至1991年的仅2例，年下降率为5.5%，低于结核感染年风险的8%年下降率。证实观察到的TM发病率与同一地区儿童暴露的平均年感染风险之间存在密切相关性，r = 0.9156（P < 0.0001）。此外，当将感染年风险作为TM发病率的百分比考虑时，这种相关性更为紧密，因为显示出约1%（0.89 - 1.39%）的稳定相关性。然而，如果参考通过感染年风险计算脑膜炎病例的表格，TM的发病率和观察到的病例数是预期的两倍。我们在218 - 384名受感染儿童中观察到1例TM，即发生TM的风险为0.19 - 0.26%，高于结核病情况最有利的国家。TM的急剧下降与巴塞罗那停止卡介苗接种同时发生，这表明它并未实质性改变5岁以下儿童发生TM风险的下降。感染年风险以及因此TM的下降主要归因于成人治疗的改善。
证实5岁以下儿童TM的发病率占感染年风险的1%。因此，当不存在直接计算感染年风险的条件时，TM发病率可用于确定感染年风险。
