Danková D, Trnka L, Svandová E
Institute of Chest Diseases, Prague, Czech Republic.
Tuber Lung Dis. 1994 Aug;75(4):266-70. doi: 10.1016/0962-8479(94)90131-7.
Mass BCG vaccination of newborns has been discontinued since 1986 in one third of the Czech Republic (30,000 newborns annually) except for babies with a high risk of tuberculosis.
The transmission and risk of tuberculosis infection were evaluated in non-BCG-vaccinated children representing a population living in satisfactory socio-economic conditions.
In 1986-92, of 184,648 children tuberculin tested at 2-year intervals, 283 were infected.
The risk of infection was low (0.04%). Infections very rarely occurred in children below the age of 1 year and the highest rate was in children 2-3 years old. The sources of infection were found in the families of only one half of the youngest children and in 10% of the older ones. In the remaining children occasional contacts with sources outside the family must be taken into account, but the mode of contact and transmission of infection were not identified. The only factor contributing to tuberculosis transmission was the high population density.
The risk of infection was low and identified sources of tuberculosis were rare in a stable population of children without evident risk factors. Children were infected by occasional contact with tuberculous cases outside of their families. The unfavourable factors associated with living in overcrowded industrialised settlements contributed to the risk of infection of non-BCG-vaccinated children.
自1986年起，捷克共和国三分之一的地区（每年30000名新生儿）已停止对新生儿进行大规模卡介苗接种，结核病高风险婴儿除外。
对生活在社会经济条件良好地区、未接种卡介苗的儿童的结核病感染传播及风险进行评估。
1986年至1992年期间，对184648名儿童每隔两年进行一次结核菌素检测，其中283名儿童受到感染。
感染风险较低（0.04%）。1岁以下儿童极少发生感染，感染率最高的是2至3岁的儿童。在最年幼儿童中，仅一半儿童的感染源来自家庭，而年龄较大儿童中这一比例为10%。对于其余儿童，必须考虑其与家庭外感染源的偶然接触，但未明确接触方式及感染传播途径。导致结核病传播的唯一因素是人口密度高。
在没有明显风险因素的稳定儿童群体中，感染风险较低，已确认的结核病感染源很少。儿童因与家庭外结核病例的偶然接触而感染。生活在工业化过度拥挤定居点的不利因素增加了未接种卡介苗儿童的感染风险。
