The children's tuberculosis clinic of the third hospital of the city was opened to fill the gap that there is no pediatric tuberculosis clinic in Shenzhen

Nandu News Reporter Li Rong On January 6, the National Clinical Research Center for Infectious Diseases and the Children's Tuberculosis Clinic of the Third People's Hospital of Shenzhen were officially opened, which is the first pediatric tuberculosis clinic in Shenzhen.

The clinic is led by Professor Lu Shuihua, the discipline leader of the Department of Pulmonary Medicine. As the chairman-elect of the Tuberculosis Branch of the Chinese Medical Association and the chairman of the School and Child Tuberculosis Branch of the China Antituberculosis Association, Lu Shuihua said, "The Children's Tuberculosis Clinic will fill the gap in this field in Shenzhen, and children in the Pearl River Delta can get timely treatment without having to go to Beijing and Shanghai." ”

9.9 million new TB infections worldwide in 2020, with 11% of children

According to the latest global TB outbreak report released by the World Health Organization, about 9.9 million people worldwide will be newly infected with TB in 2020, of which 11% will be children. According to the World Health Organization, the number of tuberculosis cases in China in 2020 was 842,000, of which 92,400 were children under 15 years old.

Lu Shuihua said that there are more than 1 million children with tuberculosis in the world, only 46% have been found, and in 2015 alone, about 240,000 children died of tuberculosis worldwide, and more than 96% occurred in children who did not receive tuberculosis treatment. Symptoms of tuberculosis in children are often atypical, some patients present with acute onset, some children present with growth retardation; in addition, due to low immunity in children, they are more prone to diseases such as tuberculous meningitis, lymph node tuberculosis, bone tuberculosis, etc., and children with primary immunodeficiency disease are often accompanied by BCG-borne diseases.

Children with TUBERCULO often do not have the typical symptoms of respiratory diseases and are prone to missed diagnosis and misdiagnosis

Compared with adult TB, the symptoms and treatment of childhood TB are very different. For adults, coughing up sputum for more than two weeks is a clear sign of tuberculosis, while pediatric patients (especially infants and young children) usually do not have the typical symptoms of respiratory diseases such as chronic cough, and the onset is more acute, mainly high fever and systemic diseases.

"Sometimes it is found that children are not like any disease, and it is necessary to consider that it may be tuberculosis," Professor Lu stressed that the first department of pediatric tuberculosis patients is often not a respiratory department, such as infection, rheumatology, orthopedics, neurology, gastroenterology, nephrology, immunology and other departments will find that there are tuberculosis children for treatment, and the doctors in these departments lack experience and awareness of pediatric tuberculosis, which may delay the optimal treatment period, and often develop into severe disease when diagnosed.

At the same time, the difference in symptoms between children and adult patients also means that the previous method of relying on sputum for tuberculosis pathogen detection is not effective, and doctors need to conduct gastric juice and stool examination to find tuberculosis bacteria; in terms of treatment, there is a lack of suitable children's anti-tuberculosis drugs on the market, and the use of adult dosage forms of anti-tuberculosis drugs will affect the treatment effect of children's tuberculosis. It should be emphasized that childhood TB should be treated according to drug sensitivity and disease development.

Fill the gap in Shenzhen where there is no pediatric tuberculosis clinic

Tuberculosis of the Third People's Hospital of Shenzhen is a national key specialty, ranking fifth in the scientific and technological value of Chinese hospitals in 2021, and ranking fourth in the Fudan edition of the "Comprehensive Ranking of Chinese Hospital Specialties". However, before that, the three hospitals in Shenzhen did not open a special children's tuberculosis clinic, and even in the whole country, there were very few experts and teams in the field of childhood tuberculosis.

In the past, when Lu Shuihua visited Shanghai, there were often patient families in the Pearl River Delta who went to Shanghai once a month, and went for a year or even longer, traveling long distances, bringing a lot of burdens to the families of the children.

"Some children have developed severe illness when they are referred, and the case fatality rate has increased significantly." Lu Shuihua said that the opening of the children's tuberculosis clinic fills the gap in this field in Shenzhen, hoping to enable children in the Pearl River Delta and even South China to get timely diagnosis and scientific treatment.

Lu Shuihua reminded that the adult immune system is relatively perfect, some adult infections may not have obvious symptoms after the onset of the disease but have been contagious, young children may be unconsciously infected by family members, delayed diagnosis often leads to aggravation of the disease, some children with genetic defects, susceptibility to mycobacteria are high-risk groups, parents must establish a sense of prevention and treatment of tuberculosis in children. BCG vaccine can significantly reduce the incidence of tuberculosis, severe illness and mortality in children, and parents must take their children to vaccinate in time.