A Study on Clinical Manifestations of Pulmonary Tuberculosis and Tuberculosis Contact Investigation in School-Age Children and Adolescents at Two Centers / 소아감염

PURPOSE: The aim of this study was to evaluate the clinical manifestations, contact history, and status of tuberculosis contact investigations in school-age children and adolescents with pulmonary tuberculosis (TB) at two centers. METHODS: This study was conducted with 54 patients in the age ranging from 10 to 18 years, who were diagnosed with pulmonary TB at the Pusan National University Hospital and Pusan National University Children's Hospital, January 2008 to December 2012. We retrospectively reviewed the medical records of the patients. RESULTS: The median age of the patients was 16 years old; 11 patients were aged 10 to 14 and 43 patients were aged 15 to 18. Among 54 patients, 19 had history of contact with pulmonary TB, 10 had contact with house members (household), and remaining 9 had contact with classmates (non-household). One out of 10 patients who had household contacts and 6 out of 9 patients who had non-household contacts were evaluated with contact investigation after the exposure to pulmonary TB. Among 7 patients who were evaluated with contact investigation, 3 were diagnosed with active pulmonary TB, 1 had latent tuberculosis infection (LTBI), and 3 had no evidence of TB or LTBI. The median period of diagnosis after the exposure to active pulmonary TB was 2 years in patients with household contacts and 0.23 years in patients with non-household contacts. CONCLUSION: This study suggested that if the contact investigation conducted properly, it would be helpful for early diagnosis and prevention of pulmonary TB.

Waist circumference distribution of Chinese school-age children and adolescents / 中华流行病学杂志

Objective To study the distribution of waist circumference (WC) in a representative group of Chinese children for establishing the Chinese WC cut-off points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 178 865 children and adolescents, aged 7-18 years-old in total. All subjects were divided into five regional groups- costal city, non-coastal city, northern rural, southern rural, and Hong Kong, for analyzing the distribution of WC. Results Large variations in WC distribution were found among the five groups for both sexes. The coastal city group had the highest P85 WC values consistently from the early school age to 18-year-old, when comparing with other groups. In contrast, southern rural group had P85 values consistently lagged behind, in both city group and in the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the northern rural groups. Catch-up trend was found in the two rural groups since peak puberty. These disparities were caused not only by factors related to socioeconomic and urban-rural but also to the geographic differences between the noah and the south. Because of the regional variation of WC, a "gradient" prevalence of central obesity was prospected among these groups. Closed associations were found between WC and height, weight and BMI in all age period. Comparison on the WC distributions between people from China, U.S.A or the Netherlands demonstrated the necessity of setting up China's own WC cutoffs.Sex and age-specific percentiles were obtained and smoothed by using the LMS method.Conclusion Data obtained from this study could be used to develop the national WC cutoff points for Chinese children and adolescents.