Characteristics of Pediatric Tuberculosis in a High Endemic Area (original) (raw)
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A 20-Year Retrospective Study of Pediatric Tuberculosis in Two Tertiary Hospitals in Rome
The Pediatric Infectious Disease Journal, 2012
Background: Tuberculosis (TB) is among the top 10 causes of child death worldwide. Nevertheless, childhood disease has been neglected by tuberculosis control programs. Methods: This was a retrospective study of patients < 16 years of age diagnosed with active TB in 2 tertiary hospitals in Rome (Italy), between 1990 and 2009. Results: Two hundred fourteen cases of active tuberculosis were identified (132 definite, 82 probable). Pulmonary involvement was the most common form (75.5%), followed by lymphadenopathy (15.4%) and central nervous system TB (11%). Fever (51.86%) and cough (40%) were the most common presenting symptoms. A total of 23.4% of children were asymptomatic on admission. Sensitivities of the tuberculin skin test and the quantiferon test were 93.4% and 97%, respectively. Both tests performed in 52 children agreed in 49 cases (94%). Sensitivities for culture, Ziehl-Neelsen staining and polymerase chain reaction were 58%, 25% and 66.3%, respectively. The adult source case was identified in 28% of cases. History of contact with a patient with active TB was associated with pulmonary TB (P = 0.0014), whereas negative history of contact was associated with lymph node (P = 0.0064) and central nervous system TB (P = 0.05). Conclusions: Our study emphasizes the difficulty in managing children with suspected TB, because the absence of constitutional symptoms cannot exclude TB, and bacteriologic confirmation is the exception. Immunologic diagnosis can be a valuable tool to identify TB-infected children because the quantiferon test showed high sensitivity in all age groups. This is of primary importance because early identification of children with latent tuberculous infection and appropriate chemoprophylaxis represent, to date, the most important tool to reduce the burden of TB.
Clinical manifestations and epidemiology of adolescent tuberculosis in Ukraine
ERJ Open Research, 2020
Background During adolescence, childhood and adult forms of tuberculosis (TB) overlap, resulting in diverse disease manifestations. Knowing which patient characteristics are associated with which manifestations may facilitate diagnosis and enhance understanding of TB pathophysiology. Methods In this cross-sectional study, we included 10–19-year-olds in Ukraine's national TB registry who started TB treatment between 2015 and 2018. Using multivariable regression, we estimated associations between patient characteristics and four presentations of TB: pleural, extrathoracic, cavitary and rifampicin-resistant (RR). We also described the epidemiology of adolescent TB in Ukraine. Results Among 2491 adolescent TB cases, 88.4% were microbiologically confirmed. RR-TB was confirmed in 16.9% of new and 29.7% of recurrent cases. Of 88 HIV-infected adolescents, 59.1% were not on antiretroviral therapy at TB diagnosis. Among 10–14-year-olds, boys had more pleural disease (adjusted OR (aOR) 2.1...
2019
The prevalence of Latent Tuberculosis Infection (LTBI) and Annual Risk of Tuberculosis Infection (ARTI), key epidemiologic indicators used to estimate the transmission of tuberculosis in the community, have not been evaluated in Romania. The aim of the study is to estimate the prevalence of LTBI and ARTI in children and adolescents from two areas with increased TB endemics: Constanta and Timis. Material and methods: We performed an epidemiological observational study to estimate the prevalence of LTBI, using tuberculin skin test (TST), in a representative sample size of the population aged 0-16 years in both areas, regardless of the presence or absence of BCG post vaccination scarring. Results: 1,928 children and adolescents were evaluated, 1,088 from Constanta (CT) and 840 from Timis (TM). The LTBI prevalence for the studied group was 12.81% (CT-11.86% and TM -14.05%), for boys 12.46% (CT-11.34% and TM-14.11%) and girls 13.21% (CT-12.53% and TM-13.98%). The prevalence of LTBI was 8...
Features of Adolescents Tuberculosis at a Referral TB'S Hospital in Tehran, Iran
Mediterranean Journal of Hematology and Infectious Diseases, 2016
OBJECTIVE: To identify the pattern of the clinical, radiological, diagnostic procedures and loss to follow -up of the diagnosed cases of active tuberculosis (TB) adolescents.METHODS: This study was a retrospective analysis of the medical records of 143 adolescents aged 10 to 18 years with tuberculosis who were admitted TB wards of National Research Institute of Tuberculosis and Lung Disease (NRITLD) in Tehran, Iran, between March 2006 and March2011. RESULTS: Of the 143 patients identified, 62.9% were females. Median age of the patients was 16 years. The contact source was identified in 47.5%.The most common presenting symptom was cough (86%).Isolated pulmonary TB (PTB) was detected in 113 patients (79%), 21 patients (14.7%) had extrapulmonary TB(EPTB), and 9 patients (6.3%) had PTB and EP TB .The most common site of EPTB was pleural (14%) .The most common radiographic finding was infiltration (61%).Positive acid fast smears were seen in 67.8%.Positive cultures for Mycobacterium tu...
Characterization of tuberculosis in children and adolescents in underdeveloped country
Hospice and Palliative Medicine International Journal
Introduction: Globally, it is estimated that two hundred thousand children died from tuberculosis from 2010 to 2012, due to certain clinical and laboratory peculiarities that difficult the diagnose and delay treatment in childhood. Objective: To characterize epidemiologically the tuberculosis in children and adolescents. Materials and methods: This is a retrospective cohort study, carried out georeferencing in the laboratory and evaluation of the density of the cases by neighborhood. Results: In the 67 patients analyzed, 36 were female and 31 were male. As for the age group, 39 patients had 11 to 14years, 12 had less than to 2years, 9 had 3 to 6years, 7 had 7 to 10years old. There were 32 positive bacilloscopies in the first examination and 30 in the second, 52 cases of pulmonary form of the disease and 52 patients were discharged for cure, but 5 deaths were also recorded in the study. There was a high prevalence of cases in the neighborhoods of Jaderlândia, Heliolândia and Coqueiro. Conclusion: The characterization of tuberculosis in the studied age group in underdeveloped country was done sucessfully. It was observed a greater prevalence mostly on poor neighborhood.
Epidemiological Investigation of Pediatric Tuberculosis in Tehran Province, 2006-2015
2016
Background: On tuberculosis control standpoint, the treatment of children with TB is not considered a priority as they rarely transmit the disease and contribute little to the maintenance of the tuberculosis epidemic. Therefor this study conducted to describe pediatric TB cases, and to identify pattern of risk factors in non-endemic communities Materials and Methods: The present cross- sectional study conducted on 139 children under-five years of old with TB in Tehran province from March 2006 to March 2015. Data were extracted from TB registry system. Data were analyzed using Stata software version, 12. Results: Overall, records on 139 children with TB had been evaluated. Most of under-five TB cases were boys (58%) and urban dwellers (88%), roughly half of the sample (54%) was diagnosed as extra- pulmonary TB, while most of them (66%) had been reported through public health networks. Treatment success rate were nearly 85%, and 11% of them had been deceased. There was a significant r...
Childhood tuberculosis: Characteristics and peculiarities
Nigerian journal of paediatrics, 2020
Tuberculosis (TB) is an important infectious disease of public health concern. The effects of TB on children in terms of morbidity and mortality is more than that of adults. These may not be unconnected with the differences in characteristics and peculiarities of the disease in children. Tuberculosis in children is usually primary, paucibacillary, characterized by difficulties in diagnosis of both drug susceptible and resistant TB associated with poor uptake of preventive therapy for those with latent infection, contacts and people living with HIV and AIDS (PLWHA) in most developing countries.While significant similarities exist between spectrum of TB occurring in adults and children, the characteristics and peculiarities of childhood TB may be unknown to policy makers and some clinicians, hence giving it less focus in control measures. The aim of this review is to highlight some of the characteristics and peculiarities of TB in children using PubMed/PubMed Central (PMC) and MEDLI...