世界卫生组织《结核病整合指南模块5:儿童和青少年结核病管理》解读

doi:10.19982/j.issn.1000-6621.20220403

中国防痨杂志 ›› 2023, Vol. 45 ›› Issue (1): 6-12.doi: 10.19982/j.issn.1000-6621.20220403

世界卫生组织《结核病整合指南模块5:儿童和青少年结核病管理》解读

樊丽超¹, 焦伟伟², 吴浩宇¹, 申阿东²(), 陈禹¹()

¹沈阳市第十人民医院学生儿童结核科,沈阳 110044
²国家儿童医学中心/首都医科大学附属北京儿童医院/北京市儿科研究所/儿科学国家重点学科/国家呼吸系统疾病临床医学研究中心/儿科重大疾病研究教育部重点实验室/儿童呼吸道感染性疾病研究北京市重点实验室,北京 100045

收稿日期:2022-10-17 出版日期:2023-01-10 发布日期:2022-12-30
通信作者: 申阿东,陈禹 E-mail:shenadong@bch.com.cn;yuchensyxk@163.com
基金资助:
辽宁省自然科学基金(2022-MS-432)

Interpretation of WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents

Fan Lichao¹, Jiao Weiwei², Wu Haoyu¹, Shen Adong²(), Chen Yu¹()

¹Department of Student and Child Tuberculosis, Shenyang Tenth People’s Hospital,Shenyang 110044, China
²Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China

Received:2022-10-17 Online:2023-01-10 Published:2022-12-30
Contact: Shen Adong,Chen Yu E-mail:shenadong@bch.com.cn;yuchensyxk@163.com
Supported by:
Natural Science Foundation of Liaoning Province(2022-MS-432)

摘要/Abstract

摘要：

2022年3月21日,世界卫生组织(Word Health Organization,WHO)发布了WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents(简称《2022年版指南》),并通过发布的实施手册为指南建议的实施提供引导。《2022年版指南》基于最新循证医学证据对儿童和青少年结核病管理加以规范,并重点更新了儿童和青少年结核病启用Xpert Ultra作为初始诊断以及利福平耐药性检测工具,启用整合的治疗决策路径,非重症患儿启用疗程4个月的治疗方案,在6周岁以下耐多药/利福平耐药结核病(MDR/RR-TB)患儿中可启用含贝达喹啉的治疗方案,在3周岁以下MDR/RR-TB患儿中可启用含德拉马尼的治疗方案,结核性脑膜炎可启用疗程6个月的强化治疗备选方案,启用向基层下沉的非中心化的结核病关怀模式和家庭为核心的整合的结核病关怀模式等内容。笔者现对《2022年版指南》进行介绍,并对其更新要点加以解读,旨在基于循证依据为我国儿童和青少年结核病诊疗领域同道提供参考。

关键词: 儿童, 青少年, 结核, 总结性报告(主题)

Abstract:

On March 21, 2022, the World Health Organization (WHO) published the WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents (2022 version Guideline), and provide guidance for the implementation of the guidance recommendations through the published implementation manual. The 2022 version Guideline standardizes the management of tuberculosis in children and adolescents based on the latest evidence-based medical evidence, and focuses on updating the use of Xpert Ultra as the initial diagnosis tool and rifampicin resistance detection tool for children and adolescents with tuberculosis; integrated treatment decision-making paths is enabled; 4-month treatment program is enabled for non-severe children; treatment program containing bedaquiline is enabled for multidrug-/rifampicin-resistant tuberculosis (MDR/RR-TB) children under the age of 6; among MDR/RR-TB children under 3 years of age, the treatment plan with delamanid can be used; the option of intensive treatment with a course of 6 months can be used for tuberculous meningitis; and the decentralized tuberculosis care model sinking to the grass-roots level and the integrated tuberculosis care model with family as the core can be used. The author now introduces the 2022 version Guideline and interprets the updated key points, aiming to provide reference for staff in the field of tuberculosis diagnosis and treatment in children and adolescents based on evidence.

Key words: Child, Adolescent, Tuberculosis, Consensus development conferences as topic

中图分类号:

R52
R725

樊丽超, 焦伟伟, 吴浩宇, 申阿东, 陈禹. 世界卫生组织《结核病整合指南模块5:儿童和青少年结核病管理》解读[J]. 中国防痨杂志, 2023, 45(1): 6-12. doi: 10.19982/j.issn.1000-6621.20220403

Fan Lichao, Jiao Weiwei, Wu Haoyu, Shen Adong, Chen Yu. Interpretation of WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents[J]. Chinese Journal of Antituberculosis, 2023, 45(1): 6-12. doi: 10.19982/j.issn.1000-6621.20220403

参考文献 6

[1]	World Health Organization. Global tuberculosis report 2021. Geneva: World Health Organization, 2021.
[2]	World Health Organization. WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents. Geneva: World Health Organization, 2022.
[3]	World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. 2nd ed. Geneva: World Health Organization, 2014.
[4]	World Health Organization. Roadmap towards ending TB in children and adolescents. 2nd ed. Geneva: World Health Organization, 2018.
[5]	World Health Organization. WHO Model List of Essential Medicines for Children-8th List, 2021, Geneva: World Health Organization,
[6]	Wolzak NK, Cooke ML, Orth H, et al. The changing profile of pediatric meningitis at a referral centre in Cape Town, South Africa. J Trop Pediatr, 2012, 58(6):491-495. doi:10.1093/tropej/fms031. doi: 10.1093/tropej/fms031. URL

[1]	王前, 王嘉, 李玉红, 刘二勇, 周林. 重视儿童结核病防治关爱儿童健康[J]. 中国防痨杂志, 2023, 45(1): 1-5.
[2]	何小谋, 罗卉, 马进宝, 任斐, 赵阿利, 袁荣. “三位一体”的关怀服务对耐多药/利福平耐药结核病患者强化期治疗的影响[J]. 中国防痨杂志, 2023, 45(1): 104-110.
[3]	陶荔莹, 徐征, 赵鑫, 李艳圆, 李亚敏, 许琰, 张亚楠, 高志东. 2021年北京市高中及以下学段入学新生肺结核筛查结果分析[J]. 中国防痨杂志, 2023, 45(1): 111-115.
[4]	尚园园, 聂文娟, 黄海荣, 初乃惠. 抗结核药物贝达喹啉与氯法齐明耐药的研究现状[J]. 中国防痨杂志, 2023, 45(1): 116-122.
[5]	王泽明, 申阿东. 《儿童结核分枝杆菌潜伏感染检测和预防性治疗》标准解读[J]. 中国防痨杂志, 2023, 45(1): 13-17.
[6]	王泽明, 申阿东. 《儿童中枢神经系统结核的诊断》团体标准解读[J]. 中国防痨杂志, 2023, 45(1): 18-24.
[7]	韩婷婷, 刘桂珍, 陈秋奇, 邓国防. 世界卫生组织《应对结核病及其共病合作行动框架》解读[J]. 中国防痨杂志, 2023, 45(1): 25-30.
[8]	李桂莲, 方敏, 姜靖伟, 王瑞欢, 钱程宇, 于晋杰, 曹滨, 许达, 赵秀芹, 李马超, 刘海灿, 孙琳, 朱渝, 万康林. 肺结核患儿胃液样本结核分枝杆菌培养阳性率提高方法的探讨[J]. 中国防痨杂志, 2023, 45(1): 31-37.
[9]	李翔, 付旭文, 许艳玲, 干玮, 杞敏, 黄瑛. CT征象联合外周血嗜酸性粒细胞对鉴别儿童胸肺型并殖吸虫病与结核性胸膜炎的价值研究[J]. 中国防痨杂志, 2023, 45(1): 38-44.
[10]	陈芳, 张小佛, 周海依, 张锋, 王曼知. 儿童抗结核药物性肝损伤状况及相关影响因素分析[J]. 中国防痨杂志, 2023, 45(1): 45-51.
[11]	任斐, 马进宝, 李荣, 杨翰, 杨虹, 武延琴, 杨新军, 党丽云. 高剂量莫西沙星短程方案对利福平耐药肺结核的疗效及适用性研究[J]. 中国防痨杂志, 2023, 45(1): 52-59.
[12]	余美玲, 张晨晨, 魏文静, 赵雨川, 卓文基, 郑磊. 体外诱导对氨基水杨酸高浓度耐药结核分枝杆菌及其突变位点研究[J]. 中国防痨杂志, 2023, 45(1): 60-66.
[13]	盛云峰, 邱美华, 陈园园, 孙丽芳, 甄利波. 树突细胞miR-17调节初始CD4⁺T淋巴细胞分化Treg/Th17失衡机制的研究[J]. 中国防痨杂志, 2023, 45(1): 67-72.
[14]	魏淑贞, 赵永, 林建, 林淑芳, 戴志松. 2017—2019年福建省结核分枝杆菌分离株基因型特征及其耐药性分析[J]. 中国防痨杂志, 2023, 45(1): 73-78.
[15]	徐银娟, 赵国连, 崔晓利, 党丽云, 康磊, 周永. 实时荧光RNA恒温检测在气管支气管结核疗效监测中的应用价值[J]. 中国防痨杂志, 2023, 45(1): 79-84.

世界卫生组织《结核病整合指南模块5:儿童和青少年结核病管理》解读

Interpretation of WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 6

相关文章 15

编辑推荐

Metrics

本文评价

友情链接