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首页> 外文期刊>Interdisciplinary perspectives on infectious diseases >Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai
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Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai

机译：儿童肺结核的诊断和治疗：孟买私营部门儿科医生实践的横断面研究

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Majority of children with tuberculosis are treated in private sector in India with no available data on management practices. The study assessed diagnostic and treatment practices related to childhood pulmonary tuberculosis among paediatricians in Mumbai s private sector in comparison with International Standards for Tuberculosis Care (ISTC) 2009. In this cross-sectional study, 64 paediatricians from private sector filled self-administered questionnaires. Cough was reported as a symptom of childhood TB by 77.8% of respondents. 38.1% request sputum smear or culture for diagnosis and fewer (32.8%) use it for patients positive on chest radiographs and 32.8% induce sputum for those unable to produce it. Sputum negative TB suspect is always tested with X-ray or tuberculin skin test. 61.4% prescribe regimen as recommended in ISTC and all monitor progress to treatment clinically. Drug-resistance at beginning of treatment is suspected for child in contact with a drug-resistant patient (67.7%) and with prior history of antitubercular treatment (12.9%). About half of them (48%) request drug-resistance test for rifampicin in case of nonresponse after two to three months of therapy and regimen prescribed by 41.7% for multidrug-resistant TB was as per ISTC. The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among paediatricians in private sector.
机译：在印度，私营部门对大多数结核病儿童进行了治疗，但尚无有关管理实践的数据。这项研究与2009年国际结核病护理标准（ISTC）相比，评估了孟买私营部门儿科医生与儿童肺结核相关的诊断和治疗方法。在这项横断面研究中，来自私营部门的64名儿科医生填写了自我管理的调查表。 77.8％的受访者表示咳嗽是儿童结核病的症状。 38.1％要求对痰涂片或培养进行诊断，较少（32.8％）的人将其用于胸部X光片阳性的患者，而32.8％的人则将痰涂片或培养物用于无法产生痰的患者。痰阴性的结核病可疑患者总是用X射线或结核菌素皮肤试验进行检查。 61.4％的人根据ISTC的建议开出了治疗方案，并且均监测临床治疗进展。怀疑与耐药患者接触的儿童（67.7％）和先前有抗结核治疗史的儿童（12.9％）在治疗开始时具有耐药性。如果在治疗2到3个月后无反应，其中约一半（48％）要求对利福平进行耐药性试验，按照ISTC的规定，针对多重耐药性结核病的治疗方案规定为41.7％。这项研究强调了私营部门儿科医生中用于管理儿童肺结核的不适当的诊断和治疗方法。

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