Trendy v incidenci tuberkulózy a netuberkulózních mykobakterióz u dětí a dorostu v České republice v letech 2001-2020

• Název práce v češtině: Trendy v incidenci tuberkulózy a netuberkulózních mykobakterióz u dětí a dorostu v České republice v letech 2001-2020
• Název v anglickém jazyce: Trends in incidence of Tuberculosis and Nontuberculous Mycobacterial Infections in years 2001-2020
• Klíčová slova: incidence, kalmetizace, lymfadenitida, Mycobacterium tuberculosis, Mycobacterium avium complex, mykobakterióza, tuberkulóza
• Klíčová slova anglicky: BCG vaccination, incidence, lymphadenitis, Mycobacterium tuberculosis, Mycobacterium avium complex, mycobacteriosis, Tuberculosis
• Akademický rok vypsání: 2018/2019
• Typ práce: disertační práce
• Jazyk práce: čeština
• Ústav: Ústav epidemiologie (13-472)
• Vedoucí / školitel: doc. MUDr. Dana Göpfertová, CSc.
• Řešitel: skrytý - zadáno a potvrzeno stud. odd.
• Datum přihlášení: 30.10.2018
• Datum zadání: 30.10.2018
• Datum potvrzení stud. oddělením: 30.10.2018
• Datum a čas obhajoby: 14.09.2022 10:00
• Datum odevzdání elektronické podoby: 30.03.2022
• Datum odevzdání tištěné podoby: 14.04.2022
• Datum proběhlé obhajoby: 14.09.2022
• Oponenti: prof. MUDr. Jana Skřičková, CSc.

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Předběžná náplň práce

Očkování proti tuberkulóze, tzv. kalmetizace, bylo v Československu zahájeno před 60 lety za úplně jiné epidemiologické situace, než je v současnosti. Povinné celoplošné očkování novorozenců se od listopadu 2010 změnilo na selektivní očkování dětí s vysokým rizikem tuberkulózní infekce. Táto práce hodnotí riziko onemocnění tuberkulózou a mykobakteriózou v 10 letech následujících po ukončení kalmetizace a srovnává je se stejně dlouhým obdobím, ve kterém byla celoplošná kalmetizace novorozenců povinná. Jedná se o deskriptivní studii s porovnáním a statistickou analýzou dat z Registru tuberkulózy v období 2001-2020. Závěrem studie je vyhodnocení incidence dětské tuberkulózy v obou srovnávaných obdobích, která je klesající (p <0,001). Trend onemocnění non-tuberkulózní mykobakteriózou ve formě krční lymfadenitidy je v prvním období klesající a nesignikantní (p=0,561), zatímco v druhém období je signifikantně vzrůstající (p <0,001) s 8 % meziročním nárůstem. Tyto závěry mé práce potvrzují, že selektivní kalmetizace rizikových dětí je v našich podmínkách dobrou vakcinační strategií. Nicméně je nutná ostražitost a pečlivé vyhledávání případů non-tuberkulózní lymfadenitidy.

Předběžná náplň práce v anglickém jazyce

BCG vaccination programs were introduced into Czechoslovakia more than 60 years ago under an entirely different epidemiological situation than that of today. Compulsory mass BCG vaccination was abolished in November 2010 and changed to a selective vaccination program for infants at high risk of contracting Tuberculosis. This work wants to ascertain the risk of Tuberculosis and non-tuberculous mycobacterial infection in 10 years following the change of the vaccination program and a comparison with the same period of mass BCG vaccination. The design of this work is a descriptive study, comparison, and statistical analysis of data for the period 2001–2020 about cases of Tuberculosis and mycobacteriosis as reported in the Tuberculosis Register. The conclusions are that the trend of TB incidence in children in both compared periods is identical and statistically significantly decreasing (p <0,001). The trend of incidence of NTM cervical lymphadenitis in children is in the first period degressive and non-significant (p=0,561). However, in the second period, the trend is significantly increasing (p <0,001), in every, compared two subsequent years is an increase of 8 %. These findings indicate that the change from mass BCG vaccination to selective vaccination of high-risk newborns and the abolishment of BCG revaccination is a promising vaccination strategy with careful watchfulness for NTM caused lymphadenitis.