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1. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

Author

Luisa Galli, Laura Lancella, Chiara Tersigni, Elisabetta Venturini, Elena Chiappini, Barbara Maria Bergamini, Margherita Codifava, Cristina Venturelli, Giulia Tosetti, Caterina Marabotto, Laura Cursi, Elena Boccuzzi, Silvia Garazzino, Pier Angelo Tovo, Michele Pinon, Daniele Le Serre, Laura Castiglioni, Andrea Lo Vecchio, Alfredo Guarino, Eugenia Bruzzese, Giuseppe Losurdo, Elio Castagnola, Grazia Bossi, Gian Luigi Marseglia, Susanna Esposito, Samantha Bosis, Rita Grandolfo, Valentina Fiorito, Piero Valentini, Danilo Buonsenso, Raffaele Domenici, Marco Montesanti, Filippo Maria Salvini, Enrica Riva, Icilio Dodi, Francesca Maschio, Luisa Abbagnato, Elisa Fiumana, Chiara Fornabaio, Patrizia Ballista, Vincenzo Portelli, Gabriella Bottone, Nicola Palladino, Mariella Valenzise, Barbara Vecchi, Maria Di Gangi, Carla Lupi, Alberto Villani, and Maurizio de Martino

Subjects
tuberculosis, children, Italian, register, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

Published
2016
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2. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

Author

Alberto Villani, Patrizia Ballista, Luisa Galli, Laura Castiglioni, Elena Chiappini, Daniele Le Serre, Samantha Bosis, Gian Luigi Marseglia, Maurizio de Martino, Giuseppe Losurdo, Laura Lancella, Maria Di Gangi, Filippo Salvini, Cristina Venturelli, Andrea Lo Vecchio, Barbara Maria Bergamini, Eugenia Bruzzese, Elena Boccuzzi, Caterina Marabotto, Susanna Esposito, Michele Pinon, Piero Valentini, Laura Cursi, Elisa Fiumana, Elio Castagnola, Grazia Bossi, Marco Montesanti, Francesca Maschio, Chiara Fornabaio, Giulia Tosetti, Elisabetta Venturini, Alfredo Guarino, Margherita Codifava, Gabriella Bottone, Icilio Dodi, Rita Grandolfo, Carla Lupi, Nicola Palladino, Mariella Valenzise, Raffaele Domenici, V. Portelli, Danilo Buonsenso, Valentina Fiorito, Barbara Vecchi, Luisa Abbagnato, Pier-Angelo Tovo, Enrica Riva, Silvia Garazzino, Chiara Tersigni, Galli, L, Lancella, L, Tersigni, C, Venturini, E, Chiappini, E, Bergamini, Bm, Codifava, M, Venturelli, C, Tosetti, G, Marabotto, C, Cursi, L, Boccuzzi, E, Garazzino, S, Tovo, Pa, Pinon, M, Le Serre, D, Castiglioni, L, LO VECCHIO, Andrea, Guarino, Alfredo, Bruzzese, Eugenia, Losurdo, G, Castagnola, E, Bossi, G, Marseglia, Gl, Esposito, S, Bosis, S, Grandolfo, R, Fiorito, V, Valentini, P, Buonsenso, D, Domenici, R, Montesanti, M, Salvini, Fm, Riva, E, Dodi, I, Maschio, F, Abbagnato, L, Fiumana, E, Fornabaio, C, Ballista, P, Portelli, V, Bottone, G, Palladino, N, Valenzise, M, Vecchi, B, Di Gangi, M, Lupi, C, Villani, A, and de Martino, M.

Subjects
Male, Pediatrics, Children, Italian, Register, Tuberculosis, Antitubercular Agents, Drug resistance, Ambulatory Care Facilities, Catalysi, lcsh:Chemistry, 0302 clinical medicine, Health care, Epidemiology, Tuberculosis, Multidrug-Resistant, 030212 general & internal medicine, Registries, Child, lcsh:QH301-705.5, Spectroscopy, Pediatric, register, biology, Incidence (epidemiology), Computer Science Applications1707 Computer Vision and Pattern Recognition, Pulmonary, General Medicine, Multidrug-Resistant, Hospitals, Pediatric, Settore MED/38, Hospitals, Computer Science Applications, Pediatric tuberculosis, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, tuberculosis, Child, Preschool, Catalysis, Molecular Biology, Physical and Theoretical Chemistry, Organic Chemistry, Inorganic Chemistry, Female, medicine.medical_specialty, Adolescent, Tuberculosi, Humans, Infant, Tuberculosis, Pulmonary, Article, Mycobacterium tuberculosis, 03 medical and health sciences, children, 030225 pediatrics, medicine, Preschool, business.industry, Public health, medicine.disease, biology.organism_classification, Children, Italian, Register, Tuberculosis, lcsh:Biology (General), lcsh:QD1-999, business
Abstract

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

Published
2016

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