Gerlach, Philipp (2023): Management der latenten tuberkulösen Infektion (LTBI) bei Kindern und Jugendlichen in Deutschland, Österreich und der Schweiz. Dissertation, LMU München: Faculty of Medicine |
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Gerlach_Philipp.pdf 2MB |
Abstract
Background Taking into account WHO´s Global End TB Strategy until 2035 and the fact that more than 2 billion people in the world are infected with Mycobacterium tuberculosis, inter-nationally coordinated struggle is needed to tackle the disease. This struggle must in-clude not only active TB disease, but also the latent form of the infection (LTBI), which is far more frequent and for which there is a lack of algorithms particularly for the pediatric setting. This study aimed to find out as much as possible about epidemi-ology and workload, but mainly diagnostic, therapeutic and follow-up approaches in the field of pediatric LTBI within the three low-TB-incidence countries Switzerland, Austria and Germany. It was conducted directly before apparition of the German-speaking medical society for pediatric infectious diseases (DGPI)´s guidelines on pe-diatric tuberculosis and thus gives an insight into modus operandi without the influ-ence of recently published guidelines. Methods We created a survey consisting of 51 questions which was then made available online for four months in late 2017. Medical societies from all three countries which are ac-tive in pediatric infectiology or pediatric pneumology as well as the German and Aus-trian public health sector and the Swiss Pulmonary League were asked to work on the survey online or with the help of personal interviews. Results A total of 173 practitioners took part in the survey. 76.1% of them prefer QuantiFER-ON over T-SPOT.TB when it comes to immunological diagnostic via IGRA. 63% vary their diagnostic approach depending on their patient´s age. Chemopreventative therapy of Isoniazid (INH) in combination with Rifampicin (RMP) seems to be largely accept-ed even though it has only recently been considered as equal to INH monotherapy. Chest X-Ray after completion of the chemopreventative regimen is conducted in 49.6% of cases. Discussion Routine TB diagnostics including CT imagery was quite popular even though there are both well-established such as CXR and promising new diagnostic technologies such as sonography. Imaging should also take place after the end of preventative therapy. Un-der-dosage remains a problem with around 41% of participants administering too low amounts of anti-TB agents in both mono- and combination therapy. It should be em-phasized that follow-up needs to take place even in preventative therapy. More teach-ing events on pediatric TB and LTBI are desirable.
Item Type: | Theses (Dissertation, LMU Munich) |
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Keywords: | LTBI, Tuberkulose, Kinder |
Subjects: | 600 Technology, Medicine 600 Technology, Medicine > 610 Medical sciences and medicine |
Faculties: | Faculty of Medicine |
Language: | German |
Date of oral examination: | 12. January 2023 |
1. Referee: | von Both, Ulrich |
MD5 Checksum of the PDF-file: | ed9a36e07893d8602a5ce84ff3a076d5 |
Signature of the printed copy: | 0700/UMD 20926 |
ID Code: | 31207 |
Deposited On: | 13. Feb 2023 10:47 |
Last Modified: | 13. Feb 2023 11:21 |