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背景:南非一个结核病高发病率(>800/10万)的郊区。目的:确定肺结核成年病人对家庭5岁以下密切接触者的结核感染率和发病率。设计:前瞻性临床研究。对象:成年结核病病人家庭周围5岁以下儿童接触者(其中>98％在新生儿时期接种过卡介苗)。检查项目:临床检查,结核菌素皮内试验,胸部X线摄影,胃液结核分支杆菌培养。结果:在与80名已登记病人(83％涂片阳性)有接触的155名5岁以下儿童中,感染率为14%,发病率为34％。2岁以下儿童病变更重(支气管内结核和支气管压迫症)。在154名年龄超过5岁的受检家庭成员中,17人培养确诊为肺结核(13人涂片阳性),并根据X线所见对16人进行抗结核治疗。结论:在结核高发区对肺结核成年病人家庭接触的儿童进行评估和采用药物预防是一项有价值的措施。在家庭青春期和成年人涂片和培养阳性肺结核的检出应强调对接触者的追踪以检出肺结核传染病人和防止结核病的扩散。
Background: South Africa is a high incidence of tuberculosis (> 800/10 million) in the suburbs. PURPOSE: To determine the prevalence and incidence of tuberculosis in adult patients with tuberculosis who are close to 5 years of age in the family. Design: Prospective clinical study. PARTICIPANTS: Contact of children under 5 years of age around the family of adult TB patients (> 98% of whom have been vaccinated against BCG in the neonatal period). Check items: clinical examination, tuberculin skin test, chest X-ray photography, gastric fluid Mycobacterium tuberculosis culture. Outcome: Among 155 155-year-old children who were exposed to 80 registered patients (83% smear-positive), the infection rate was 14% with a prevalence of 34%. Children under the age of 2 are more diseased (bronchial tuberculosis and bronchial compression). Of the 154 family members examined over the age of 5, 17 developed tuberculosis (thirteen smear-positive) and treated 16 on the basis of X-rays. CONCLUSIONS: Assessing and using drug prophylaxis in families with tuberculosis in adult-onset tuberculosis in high-risk areas is a valuable intervention. Detection of smear-positive and adult-positive tuberculosis in adolescent and adult families should emphasize the tracking of contacts to detect cases of tuberculosis and prevent the spread of tuberculosis.