CHAPTER


DOI :10.26650/B/CH32.2024.010.011   IUP :10.26650/B/CH32.2024.010.011    Full Text (PDF)

Follow-up and Community Care of the Child with Tuberculosis Infection

Neslihan Mete AtaseverSelda Hançerli Törün

Tuberculosis (TB) is transmitted to a child by inhalation of Mycobacterium tuberculosis bacilli, usually because of contact with an adult or adolescent pulmonary TB case. It is usually subclinical with no signs and symptoms of the disease in the infected child. The most contagious patients are children with an acid-resistant bacillus-positive sputum as well as cavitated pulmonary and laryngeal TB. Children with smear-negative TB are less contagious. The risk of transmission to people who have close and long-term contact with the patient is high. They may be family members, friends with whom they share the same house or schoolmates. With effective treatment, the number of bacilli and frequency of cough rapidly decrease within days. Infectiousness of patients practically ceases in 2–3 weeks with effective treatment. TB infection types also include latent TB infection. The diagnosis is made with a positive interferon-gamma release test or tuberculin skin test. Latent TB is a condition that does not have symptoms, signs, or laboratory or radiological findings of the disease; that is, it is not an active disease. TB is a clinical condition that can affect all organs and systems, although it mostly involves the lungs. Symptoms may include physical examination and radiology and microbiology findings. Accurate reporting of both clinical and confirmed cases of childhood TB is critical to understanding TB epidemiology in a population and providing adequate resources for pediatric patients. Prevention of childhood TB can be a useful quality measure for TB programs. Tackling infections of human immunodeficiency virus and TB needs to address the underlying economic, social, and political conditions leading to infection and illness, preventing affected individuals from making full use of current effective measures, including diagnosis and treatment.


DOI :10.26650/B/CH32.2024.010.011   IUP :10.26650/B/CH32.2024.010.011    Full Text (PDF)

Tüberküloz İnfeksi̇yonu Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Neslihan Mete AtaseverSelda Hançerli Törün

Tüberküloz bir çocuğa, genellikle ergen ya da erişkin akciğer tüberkülozlu bir olguyla teması sonucu M. tuberculosis basillerinin inhalasyonu yolu ile bulaşır. Genellikle subkliniktir, enfekte çocuklarda hastalığa ait bulgu ve belirti yoktur. Bulaştırıcılığı en yüksek olan hastalar; balgam mikroskopisinde aside dirençli basil pozitifliği, larinks ve kaviteli akciğer tüberkülozu olan hastalardır. Yayma negatif olan tüberküloz hastalarının bulaştırıcılığı daha azdır. Bulaştırıcı hasta ile yakın ve uzun süreli temaslı kişilere bulaşma riski fazladır. Bu kişiler; aile üyeleri, okul arkadaşları, ev arkadaşları olabilir. Etkili tedaviler ile günler içinde basil sayısı ve öksürük sıklığı azalmaktadır. Hastaların bulaştırıcılığı, etkili tedaviler ile 2-3 haftada sona erer. Latent tüberküloz enfeksiyonu olarak da adlandırılan tüberküloz enfeksiyonu tanısı tüberkülin deri testi veya interferon gama salınım testi pozitifliği ile konulur. Sonuç olarak latent tüberküloz, hastalığın bulguları, semptomları, laboratuvar veya radyoloji bulguları olmayan aktif hastalık olmayan durumdur. Tüberküloz hastalığı tüm organ ve sistemleri tutmakla birlikte en çok akciğerleri tutan bir klinik durumdur. Semptom verebilir, fizik muayene, mikrobiyoloji ve radyoloji bulguları olabilir. Hem klinik hem de doğrulanmış çocukluk çağı tüberkülozu vakalarının doğru bir şekilde bildirilmesi, bir toplumda tüberküloz epidemiyolojisinin anlaşılması ve pediatrik hastalar için yeterli kaynakların sağlanması açısından kritik öneme sahiptir. Çocukluk çağı tüberkülozunun önlenmesi, tüberküloz programları için yararlı bir kalite ölçüsü olabilir. İnsan immün yetersizlik virüsü (HİV) ve tüberküloz ile mücadele, enfeksiyon ile hastalığa yol açan, etkilenenlerin teşhisi ve ilaçlar da dahil olmak üzere mevcut etkili önlemlerden tam olarak yararlanmasını engelleyen altta yatan sosyal, ekonomik ve politik koşulların ele alınmasını gerektirir.



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