Abstract：
Smear-positive adults with tuberculosis are the main source of childhood tuberculosis. The evaluation of children exposed to tuberculosis and determination of the disease stages are the cornerstones of managing childhood tuberculosis.
To determine the frequency of tuberculous contact, latent tuberculosis infection and tuberculosis disease in children who were in contact with smear-positive adults.
This is a single-centre, retrospective study. The medical records of children exposed to tuberculosis (<18 years old) between 2014 and 2018 were investigated. After diagnosing the index cases, the children were referred to the hospital. To identify the children in contact with adults with tuberculosis, a careful medical history, demographic features and physical examination, tuberculin skin test, postero-anterior and lateral chest radiographs, and, if necessary, chest computed tomography and microbiological tests were undertaken. The children\'s final diagnosis, treatment regimens and follow-up were documented. The sensitivity, specificity and positive and negative predictive values, tuberculin skin test and chest radiograph imaging were assessed and compared with computed tomography results.
A total of 150 paediatric patients were exposed to 88 index cases. These were fathers in 29.3% of cases and mothers in 10% of cases. Of the children, 131 (87.3%) were asymptomatic, and physical examination was normal in all children, apart from one who had respiratory symptoms. The tuberculin skin test results were positive in 60 (43%) patients and chest radiograph was abnormal in 100 (66%) children. Findings were consistent with tuberculosis in 34 (40%) of the 84 patients who underwent computed tomography. Fifty (38.5%) of the remaining children were defined as having been in contact with a case of tuberculosis, 41 (31.5%) had latent tuberculous infection and 39 (30%) had tuberculosis disease.
Pulmonary tuberculosis is asymptomatic in most children but with meticulous use of computed tomography it can be detected in asymptomatic children who have had close contact with tuberculosis.Abbreviation: AFB: acid-fast bacilli; AUC: area under the curve; BCG: bacillus Calmette-Guérin; CI: confidence interval; CT: computed tomography; CXR: chest radiograph; HIV: human immunodeficiency virus; ICD-10: International Classification of Diseases 10; LTBI: latent tuberculosis infection; MDR-TB: multi-drug-resistant tuberculosis; NPV: negative predictive value; PCR: polymerase chain reaction; PPV: positive predictive value; ROC: receiver operating characteristics; SD: standard deviation; TB: tuberculosis; TST: tuberculin skin test; XDR-TB: extensively drug-resistant tuberculosis.
To determine the frequency of tuberculous contact, latent tuberculosis infection and tuberculosis disease in children who were in contact with smear-positive adults.
This is a single-centre, retrospective study. The medical records of children exposed to tuberculosis (<18 years old) between 2014 and 2018 were investigated. After diagnosing the index cases, the children were referred to the hospital. To identify the children in contact with adults with tuberculosis, a careful medical history, demographic features and physical examination, tuberculin skin test, postero-anterior and lateral chest radiographs, and, if necessary, chest computed tomography and microbiological tests were undertaken. The children\'s final diagnosis, treatment regimens and follow-up were documented. The sensitivity, specificity and positive and negative predictive values, tuberculin skin test and chest radiograph imaging were assessed and compared with computed tomography results.
A total of 150 paediatric patients were exposed to 88 index cases. These were fathers in 29.3% of cases and mothers in 10% of cases. Of the children, 131 (87.3%) were asymptomatic, and physical examination was normal in all children, apart from one who had respiratory symptoms. The tuberculin skin test results were positive in 60 (43%) patients and chest radiograph was abnormal in 100 (66%) children. Findings were consistent with tuberculosis in 34 (40%) of the 84 patients who underwent computed tomography. Fifty (38.5%) of the remaining children were defined as having been in contact with a case of tuberculosis, 41 (31.5%) had latent tuberculous infection and 39 (30%) had tuberculosis disease.
Pulmonary tuberculosis is asymptomatic in most children but with meticulous use of computed tomography it can be detected in asymptomatic children who have had close contact with tuberculosis.Abbreviation: AFB: acid-fast bacilli; AUC: area under the curve; BCG: bacillus Calmette-Guérin; CI: confidence interval; CT: computed tomography; CXR: chest radiograph; HIV: human immunodeficiency virus; ICD-10: International Classification of Diseases 10; LTBI: latent tuberculosis infection; MDR-TB: multi-drug-resistant tuberculosis; NPV: negative predictive value; PCR: polymerase chain reaction; PPV: positive predictive value; ROC: receiver operating characteristics; SD: standard deviation; TB: tuberculosis; TST: tuberculin skin test; XDR-TB: extensively drug-resistant tuberculosis.
摘要：
■涂片阳性成人结核病是儿童结核病的主要来源。对暴露于结核病的儿童的评估和疾病阶段的确定是管理儿童结核病的基石。
■为了确定结核性接触的频率，与涂片阳性成人接触的儿童的潜伏性结核感染和结核病。
■这是一个单中心，回顾性研究。调查了2014年至2018年间暴露于结核病（<18岁）的儿童的医疗记录。在诊断指标病例后，孩子们被送往医院。为了识别与患有结核病的成年人接触的儿童，仔细的病史,人口统计特征和体检，结核菌素皮肤试验,后前和外侧胸片，and,如有必要,进行胸部计算机断层扫描和微生物检查.儿童的最终诊断，记录治疗方案和随访情况.敏感性,特异性和阳性和阴性预测值，对结核菌素皮肤试验和胸片成像进行了评估，并与计算机断层扫描结果进行了比较。
■共有150名儿科患者暴露于88个指数病例。29.3％的病例是父亲，10％的病例是母亲。孩子们，131例（87.3%）无症状，所有孩子的体检都是正常的，除了有呼吸道症状的人。60例（43％）患者的结核菌素皮肤试验结果为阳性，100例（66％）儿童的胸片异常。在接受计算机断层扫描的84例患者中，有34例（40％）的发现与结核病一致。其余50名(38.5%)儿童被定义为接触过肺结核病例,41例（31.5％）有潜伏性结核感染，39例（30％）有结核病。
■在大多数儿童中，肺结核是无症状的，但在与肺结核密切接触的无症状儿童中，通过使用计算机断层扫描可以检测到肺结核。缩写：AFB：抗酸杆菌；AUC：曲线下面积；卡介苗：卡介苗；CI：置信区间；CT：计算机断层扫描；CXR：胸片；HIV：人类免疫缺陷病毒；ICD-10：国际疾病分类10；LTBI：潜伏性结核感染；MDR-TB：耐多药结核；NPV：耐多药结核病；ROV：标准预测结核病：TTB聚合酶链反应阳性；
■为了确定结核性接触的频率，与涂片阳性成人接触的儿童的潜伏性结核感染和结核病。
■这是一个单中心，回顾性研究。调查了2014年至2018年间暴露于结核病（<18岁）的儿童的医疗记录。在诊断指标病例后，孩子们被送往医院。为了识别与患有结核病的成年人接触的儿童，仔细的病史,人口统计特征和体检，结核菌素皮肤试验,后前和外侧胸片，and,如有必要,进行胸部计算机断层扫描和微生物检查.儿童的最终诊断，记录治疗方案和随访情况.敏感性,特异性和阳性和阴性预测值，对结核菌素皮肤试验和胸片成像进行了评估，并与计算机断层扫描结果进行了比较。
■共有150名儿科患者暴露于88个指数病例。29.3％的病例是父亲，10％的病例是母亲。孩子们，131例（87.3%）无症状，所有孩子的体检都是正常的，除了有呼吸道症状的人。60例（43％）患者的结核菌素皮肤试验结果为阳性，100例（66％）儿童的胸片异常。在接受计算机断层扫描的84例患者中，有34例（40％）的发现与结核病一致。其余50名(38.5%)儿童被定义为接触过肺结核病例,41例（31.5％）有潜伏性结核感染，39例（30％）有结核病。
■在大多数儿童中，肺结核是无症状的，但在与肺结核密切接触的无症状儿童中，通过使用计算机断层扫描可以检测到肺结核。缩写：AFB：抗酸杆菌；AUC：曲线下面积；卡介苗：卡介苗；CI：置信区间；CT：计算机断层扫描；CXR：胸片；HIV：人类免疫缺陷病毒；ICD-10：国际疾病分类10；LTBI：潜伏性结核感染；MDR-TB：耐多药结核；NPV：耐多药结核病；ROV：标准预测结核病：TTB聚合酶链反应阳性；
