结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

结核病新疫苗研究概况

长期以来,结核病对人类健康构成了严重威胁.随着结核分枝杆菌全基因组测序工作的完成和有效抗原的不断发现,有关结核病新疫苗的研究进展迅速,多种结核病新疫苗已进入临床试验阶段.如何对已接种卡介苗人群、结核分枝杆菌隐性感染人群和免疫缺陷人群进行有效的接种是结核病新疫苗必须解决的问题.基础研究与动物实验、临床试验的相互印证有助于各项研究的深入及结核病新疫苗的改进和择选.     

Childhood tuberculosis

OBJECTIVE: This review paper on tuberculosis in children aims at describing the classical pathogenic findings and to discuss practical features for diagnosis, treatment and prevention, based on Brazilian official rules. METHODS: The author reviews the last 5 years literature on the subject using as sources Medline, Ministry of Health official publications and Brazilian medical publication not included in the Index Medicus, as well. RESULTS: A fluxogram is described for the diagnosis of tuberculosis in children and presented as a proposal for implantation in low complexity health services. Figures displaying tuberculosis treatment models proposed by the Ministry of Health are also showed. New prevention concepts introduced in the last 5 years are presented. CONCLUSIONS: Tuberculosis in children remains a diagnostic challenge. Treatment rules have been well defined. Prevention measures should be reinforced.     

Prospects for elimination of childhood tuberculosis: the role of new vaccines

Control of childhood tuberculosis must be considered in the context of active tuberculosis disease among adults, who form the main reservoir of transmission. The elimination target of the Stop TB Partnership is a reduction of global incidence to less than one case per million per year by 2050. There is an urgent need for a new, safe and effective tuberculosis vaccine that prevents all forms of tuberculosis, in all age groups and in HIV-infected people. Bacillus Calmette-Guérin (BCG) vaccination protects against disseminated forms of childhood tuberculosis, but protection is variable against pulmonary tuberculosis and adult disease. 14 new tuberculosis vaccines have entered human clinical trials, including viral-vectored vaccines, recombinant fusion proteins, recombinant BCG vaccines and inactivated whole or fragmented mycobacteria. Effective pre-exposure and postexposure vaccination, in conjunction with mass campaigns, is the most promising tuberculosis control strategy to approach the elimination target by the middle of the 21st century.     

Childhood tuberculosis: public health and contact tracing

Contact tracing is extremely useful to detect patients with latent tuberculosis (TB) infection and should be followed by preventive therapy. When properly applied it can have an impact on morbidity and mortality, especially among children. In most industrialised countries the decline in the risk of infection due to better overall health and effective TB control measures is likely to result in the disappearance of tuberculosis as a public health problem; therefore the cost-benefit of contact tracing is likely to be less than in the developing world. However, given an infection prevalence of up to 40% in adolescence and the more immediate need to target scarce resources at treating active infectious cases, developing countries cannot extend the practice of contact tracing and preventive therapy beyond the very young and groups at high risk. In developing countries more benefits are likely to arise from widespread and effective application of the DOTS strategy for the prevention and the control of tuberculosis in both adults and children. Diagnosis and treatment of known infectious cases must necessarily precede a recommendation for contact tracing, however great the perceived impact may be. In the interim, political commitment to ensure global equality in accessing health care, research to improve screening procedures, lower costs of treatment through shorter regimens and the application of comprehensive measures for tuberculosis prevention and control are desperately needed.     

Childhood tuberculosis: treatment strategies and recent advances

Over the past 20 years, several major studies have shown that 6-month therapy, initially using isoniazid, rifampin and pyrazinamide, is highly effective and extremely safe for the treatment of most forms of childhood tuberculosis. The various drug schedules and frequency of administration will be reviewed. Directly observed therapy is an essential component of a paediatric tuberculosis treatment plan, though using it does not solve all problems with adherence to treatment. As the rates of drug-resistant tuberculosis increase around the world, special aspects of paediatric tuberculosis will have to be considered when designing treatment regimens for children. Finally, the next frontier of antituberculosis therapy may be the manipulation of the host immune system.     

Childhood tuberculosis in Serbia

The objective of this study was to establish the tuberculosis incidence and mortality in children in Serbia in the period 1992-2002. There were 280 reported cases. The average annual incidence rate was 1.79/100,000 (95% confidence interval, 0.92-3.13). The rate was higher in girls than in boys. Eleven children died. The average annual mortality rate was 0.10/100,000 (95% confidence interval, 0.01-0.56). The mortality rates for both boys and girls were higher in the age group 0-4 years than in older age group.