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Lancet Infect Dis：儿童耐药性结核病的全球负担

2016-11-18 xing.T MedSci原创

儿童耐药性结核病
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儿童患耐药性结核病的人数远高于被诊断的人数，并且有大量的耐药性感染患儿。这一发现对在世界上一些地区的经验治疗和预防治疗的方法有一定的影响。

在感染结核分枝杆菌后，儿童发生结核病的风险明显增加，结核病是一个诊断具有挑战性的疾病。在估计儿童结核病的新方法中突出了发病与结核分枝杆菌感染之间的差距，并提示与已被确诊的人数相比，有更多的耐异烟肼和耐多药（MDR）结核病人数。由于其他类型的耐药性或抽样的不确定性，尚未有研究量化耐药性结核杆菌感染的负担。

最近，有研究人员将儿童结核病的一个数学模型与结核杆菌耐药模式分析相结合产生了一个国家、区域和全球层面的针对耐药性感染和疾病的估计模型。研究人员使用来自于WHO抗结核耐药性监测全球项目的数据来确定耐药性，该项目数据来自于1988年至2014年期间的调查和监测报告。研究人员将用贝叶斯方法获得的按每个国家1000的抽样比例与用10,000样本来估计全国的结核发病率与结核分枝杆菌感染率相结合，估计了国家耐异烟肼、耐利福平、耐多药（MDR）、耐氟喹诺酮类药物、耐二线注射药，以及耐氟喹诺酮类药物和二线注射药的超级耐多药结核病的比例。

研究者估计在2014年有850,000例结核患儿；58,000例为耐异烟肼结核病，25,000例为耐多药结核病以及1200例耐二线注射药结核病。研究者估计6700万儿童感染了结核分支杆菌；500万人为耐异烟肼，200万人为耐多药和100,000人为耐二线注射药结核菌感染。非洲和东南亚的儿童结核病人数最多，但地中海东部地区、欧洲地区和西太平洋地区也对耐药结核病的负担有很大的贡献，因为他们有更高的耐药性比例。

儿童患耐药性结核病的人数远高于被诊断的人数，并且有大量的耐药性感染患儿。这一发现对在世界上一些地区的经验治疗和预防治疗的方法有一定的影响。

原始出处：

Dodd PJ,et al. Global burden of drug-resistant tuberculosis in children: a mathematical modelling study. Lancet Infect Dis. 2016 Oct;16(10):1193-201.

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    2017-05-10 cmj8wellington

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    2017-01-26 xiangyuzhou971

    #耐药性结核病#

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    2017-09-19 howi

    #Lancet#

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    2016-11-20 huhuaidong387

    #结核#

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    2016-11-18 阿玖

    积分看视频

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