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捷克斯洛伐克于40年前开始应用卡介苗接种规程,当时结核病流行情况与现在有明显差别。于1986年在一个选择的地区内,除高发结核病人群和家长要求接种外,停止新生儿强制性普种卡介苗。 本研究的目的是确定在165 854名新生儿中,经六年随访观察,年结核感染率和感染儿童中发病率。0-6岁儿童中平均年结核感染率是低的(0.046％)。未发现增加年感染率的因素。31名儿童诊断为原发性结核(7/10万人年),相当于15.5％感染儿童从感染到疾病的发病率。大部分病人无病状和病情轻微,均为定期检查发现。该研究结果推荐可把普种卡介苗改为选择性高危险新生儿接种。同时应考虑涉及到移民,生活条件的社会和经济方面,和群众以及医务人员对接种的态度。
Czechoslovakia began applying BCG vaccination 40 years ago when there was a clear difference in the prevalence of tuberculosis. In 1986, in a selected area, mandatory neonatal BCG vaccination was stopped except when the population of high-risk TB patients and their parents requested vaccination. The purpose of this study was to determine the prevalence of annual tuberculosis and morbidity among infected children in 165 854 newborns after six-year follow-up. The average rate of annual tuberculosis infection among children aged 0-6 is low (0.046%). No factors were found to increase the annual infection rate. Thirty-one children were diagnosed with primary tuberculosis (7/10 million person-years), the equivalent of 15.5% of infected children from infection to disease. Most patients with no symptoms and mild illness, are regularly found. The results suggest that universal BCG can be changed to selective high-risk neonatal vaccination. At the same time, we should consider the social and economic aspects related to immigration and living conditions, as well as the attitude of people and medical staff on vaccination.