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High prevalence of infection and low incidence of disease in child contacts of patients with drug-resistant tuberculosis: a prospective cohort study
- Source :
- Archives of Disease in Childhood, Archives of Disease in Childhood, 2019, 104 (7), pp.622-628. ⟨10.1136/archdischild-2018-315411⟩
- Publication Year :
- 2018
-
Abstract
- ObjectiveWe aimed to measure the prevalence and incidence of latent tuberculosis infection (LTBI) and tuberculosis (TB) disease in children in close contact with patients with drug-resistant TB (DR-TB) in a country with high DR-TB prevalence.Design and settingThis is a prospective cohort study of paediatric contacts of adult patients with pulmonary DR-TB in Armenia. Children were screened using tuberculin skin test, interferon-gamma release assay and chest X-ray at the initial consultation, and were reassessed every 3–6 months for a period of 24 months. Children did not receive preventive treatment.Main outcome measuresPrevalence and incidence of LTBI and TB disease; factors associated with prevalent LTBI.ResultsAt initial evaluation, 3 of the 150 children included were diagnosed with TB disease (2.0%). The prevalence of LTBI was 58.7%. The incidence of LTBI was 19.9 per 100 children per year, and was especially high during the first 6 months of follow-up (33.3 per 100 children per year). No additional cases with incident disease were diagnosed during follow-up. After adjustment, prevalent LTBI was significantly associated with the child’s age, sleeping in the same house, higher household density, the index case’s age, positive smear result and presence of lung cavities.ConclusionsChildren in close contact with patients with DR-TB or in contact with very contagious patients had an increased risk of prevalent LTBI. Although none of the children developed TB disease during a 2-year follow-up period, screening for symptoms of TB disease, based on the prevalence of disease at recruitment, together with follow-up and repeated testing of non-infected contacts, is highly recommended in paediatric contacts of patients with DR-TB.
- Subjects :
- Male
Pediatrics
Disease
MESH: Armenia
infectious diseases
0302 clinical medicine
drug-resistance
MESH: Child
Epidemiology
Tuberculosis, Multidrug-Resistant
Prevalence
MESH: Incidence
Prospective Studies
Prospective cohort study
Child
Index case
MESH: Middle Aged
Latent tuberculosis
Incidence (epidemiology)
Incidence
MESH: Infant, Newborn
MESH: Latent Tuberculosis
Armenia
Middle Aged
MESH: Infant
tuberculosis
Child, Preschool
Female
epidemiology
Adult
medicine.medical_specialty
Tuberculosis
Tuberculin
Global Child Health
03 medical and health sciences
Latent Tuberculosis
030225 pediatrics
medicine
Humans
MESH: Prevalence
MESH: Tuberculosis, Multidrug-Resistant
[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics
MESH: Humans
business.industry
screening
MESH: Child, Preschool
Infant, Newborn
Infant
MESH: Adult
medicine.disease
bacterial infections and mycoses
MESH: Male
MESH: Prospective Studies
Pediatrics, Perinatology and Child Health
business
MESH: Female
Subjects
Details
- ISSN :
- 14682044 and 00039888
- Volume :
- 104
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Archives of disease in childhood
- Accession number :
- edsair.doi.dedup.....a8889172ddad3a8b4e02e3b531b7e251