埃塞俄比亚西达马州哈瓦萨哈瓦萨大学综合专科医院儿童结核病诊断模式。

IF 1.7 Q2 PEDIATRICS
Pediatric health, medicine and therapeutics Pub Date : 2022-11-09 eCollection Date: 2022-01-01 DOI:10.2147/PHMT.S380092
Kefyalew Taye, Nagasa Tolesa, Agete Tadewos, Worku Ketema
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引用次数: 0

摘要

背景:由于儿童结核病缺乏细菌的性质和难以获得适当的幼儿痰样本,诊断儿童结核病(TB)很困难。儿童结核病需要早期发现和护理,因为它会迅速发展到较晚期阶段。本研究旨在确定埃塞俄比亚阿瓦萨的阿瓦萨大学综合专科医院所有形式的儿童结核病诊断模式。方法:对2017年2月1日至2021年1月30日在儿科病房诊断并治疗结核病的175名儿童进行回顾性横断面研究。使用儿童病历和儿科病区日志,通过结构化核对表提取相关数据。采用SPSS 23.0版本进行数据录入和统计分析。结果:175例患儿中,以发热为主要临床症状166例(94.9%),其次为体重减轻154例(88%),咳嗽136例(77.7%)。88例患儿中27例(30.6%)胃吸液结核Xpert MTB/Rif阳性,其中3/40例(7.5%)细针吸细胞学(FNAC)结核阳性,19/66例(28.8%)脑脊液分析(CSF)提示结核,10/29例(34.5%)涂片结核阳性,70/162例(43.2%)胸片怀疑结核。结论:尽管最近在快速微生物检测方面取得了突破,如Xpert MTB/Rif,但本研究显示,超过一半的儿童(89/175)(51%)仅根据临床标准治疗结核病。这将大大低估疾病的真实性质,使他们容易受到虐待。因此,为了在我们的环境中适当治疗这种疾病和管理患者,需要改进对儿童结核病的微生物诊断,我们呼吁扩大提供和使用更敏感和更具体的诊断技术,以避免这些问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patterns of Childhood Tuberculosis Diagnosis in Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama Regional State, Ethiopia.

Background: Because of the pauci bacillary nature of childhood tuberculosis and the difficulties in obtaining proper sputum samples from young children, diagnosing childhood tuberculosis (TB) is difficult. Childhood TB needs early identification and care since it advances swiftly to more advanced stages. This study was aimed to determine the patterns of all forms of childhood tuberculosis diagnosis at Hawassa University Comprehensive Specialized Hospital in Hawassa, Ethiopia.

Methods: A retrospective cross-sectional study was conducted from February 1, 2017 to January 30, 2021 among 175 children diagnosed and treated for tuberculosis in the pediatric ward. Children medical charts and pediatrics ward logbook were used to extract pertinent data by structured checklists. SPSS version 23.0 was used for data entry and statistical analysis.

Results: Of 175 children, fever was the leading clinical symptoms and diagnosed in 166 (94.9%) children followed by weight loss (154, 88%), and cough (136, 77.7%). In twenty seven out of 88 (30.6%) children, gastric aspirate was positive for TB infection by Xpert MTB/Rif, while 3/40 (7.5%) were positive for TB using fine needle aspiration cytology (FNAC), 19/66 (28.8%) had suggestive TB by cerebrospinal fluid analysis (CSF), 10/29 (34.5%) were smear positive for TB and 70/162 (43.2%) were suspected for TB by chest X-ray.

Conclusion: Despite recent breakthroughs in quick microbiological detection, such as Xpert MTB/Rif, this study revealed that more than half of the children, 89/175 (51%), were treated for TB diseases solely based on clinical criteria. This will significantly underestimate the true nature of the illness or disease and make them vulnerable to mistreatment. As a result, in order to appropriately treat the disease and manage patients in our settings, getting a microbiological diagnosis of childhood tuberculosis requires improvement, and we call for expanded availability and use of a more sensitive and specific diagnostic technique to circumvent these concerns.

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