Epidemiology of tuberculosis among children in the United States: 1985 to 1994

Ussery, Xilla T.; Valway, Sarah E.; McKenna, Matthew T.; Cauthen, George M.; McCray, Eugene; Onorato, Ida M.

doi:10.1097/00006454-199608000-00013

Cited by 72 publications

(53 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3,4 Much of the pediatric disease was identified in minority populations, especially in children from large cities, mirroring the increasing epidemic in adults.…”

mentioning

confidence: 99%

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Dankner

Davis

2000

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Objective. To determine the role of Mycobacterium bovis in active pediatric tuberculosis (TB) in a United States-Mexico border region.Method. We reviewed all new cases of pediatric (<15 years old) TB presenting to San Diego hospitals and clinics from 1980 to 1997. Patients were categorized by age, ethnicity, country of origin, culture results, and disease manifestations. Case definitions were similar to those used by the Centers for Disease Control and Prevention. M bovis was distinguished from Mycobacterium tuberculosis by standard biochemical tests.Results. The median age of the 563 identified patients was 4.1 years old. The yearly incidence began rising in 1989 and peaked in the mid-1990s. Hispanics constituted 78.9% of the patients, but they were less likely to be foreign-born (21.6%) than were black children and Asian/ Pacific Islanders. Overall, M bovis caused 10.8% of all TB during this period. Of the 180 patients with positive culture results, however, M bovis accounted for 33.9% and M tuberculosis 66.1%. This high percentage of M bovis infections was largely attributable to its contribution to extrapulmonary TB (55.2% of all culture-positive specimens). M bovis patients were also even more likely to be Hispanic (90.2%), to present with extrapulmonary disease (95.1%), and to be older than 12 months (96.8%).Conclusion. These data demonstrate the dramatic impact of this underappreciated cause of zoonotic TB on US children at the Mexican border and underscore the need for cross-collaboration to enforce existing Mexican pasteurization laws. Pediatrics 2000;105(6). URL: http:// www.pediatrics.org/cgi/content/full/105/6/e79; pediatric tuberculosis, Mycobacterium bovis, Mycobacterium tuberculosis, zoonotic tuberculosis, extrapulmonary tuberculosis, United States-Mexico border area.ABBREVIATIONS. HIV, human immunodeficiency virus; TB, tuberculosis; CDC, Centers for Disease Control and Prevention; PPD, purified protein derivative; INH, isoniazid; AFB, acid-fast bacillus.B eginning in the mid-1980s, a sharp increase in the incidence and prevalence of tuberculous disease in the United States reversed the steady decline of the last several decades. This increase, which persisted through the early-to mid-1990s, was fueled by the human immunodeficiency virus (HIV) epidemic and by an increasing proportion of active disease in foreign-born individuals.1,2 Although most of the attention was directed toward the significant rise of disease in adults, there was an alarming increase in the pediatric-aged population as well. 3,4 Much of the pediatric disease was identified in minority populations, especially in children from large cities, mirroring the increasing epidemic in adults. 3Traditional teaching has stressed that children with tuberculous disease are sentinel events for active adult disease and that preadolescents usually acquire disease from close contact with a family member or other adult household contact.4 Because aerosols are the route of transmission to these pediatric patients, Mycobacterium tubercu...

show abstract

“…3,4 Much of the pediatric disease was identified in minority populations, especially in children from large cities, mirroring the increasing epidemic in adults.…”

mentioning

confidence: 99%

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Dankner

Davis

2000

Pediatrics

View full text Add to dashboard Cite

show abstract

“…However, the complete identification of pediatric TB cases is important, as such cases are sentinel events. [4][5][6] Previous completeness of reporting studies in adults have utilized a variety of sources. These have included medical records, 33,34 billing records, 33 death certificates, 35,36 pathology 37 and autopsy reports, 29,36 pharmacy records 38,39 and ICD-9-CM codes.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Pediatric TB cases are sentinel events in public health, as children with TB disease represent recent transmission within the community, generally from family members. 4,6 While accurate surveillance of pediatric TB, including those children co-infected with HIV, is critical, the completeness of such surveillance in children has not been addressed in a systematic study.…”

mentioning

confidence: 99%

“…7 Since the late 1980s, the Bureau of TB Control has surveyed clinical microbiology laboratories for positive cultures for Mycobacteria tuberculosis; however, only 10% to 50% of cases of pediatric TB are culture positive for M. tuberculosis. 4,8,9 The NYC DOH and the Centers for Disease Control and Prevention (CDC) have also sponsored two ongoing active surveillance programs to assess co-infection with HIV and TB in children: the Pediatric Spectrum of Disease and Pediatric AIDS Surveillance. 10,11 To assess the completeness of reporting of pediatric TB cases to the NYC DOH Bureau of TB Control from January 1993 to December 1995, hospital-based alternative surveillance was developed to detect previously unreported cases of TB in children in our targeted surveillance area.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Completeness of pediatric TB reporting in New York City

Gabriel¹,

Saiman²,

Kaye³

et al. 2003

Public Health Reports

View full text Add to dashboard Cite

SYNOPSISObjectives. Accurate surveillance of tuberculosis (TB) in children is critical because such cases represent recent transmission, but surveillance is difficult as only 10% to 50% of cases are culture-confirmed. Hospital-based sources were used to develop alternative surveillance to assess completeness of reporting for pediatric TB in northern Manhattan and Harlem from 1993 through 1995.Methods. Alternative surveillance sources included ICD-9-CM hospital discharge codes for active TB and gastric aspirate reports. Cases identified by alternative surveillance were compared with cases previously reported to the New York City Department of Health (NYC DOH).Results. Alternative surveillance detected 25 cases of possible pediatric TB, of which four (16%) had never been reported to the NYC DOH and three (12%) had been reported as suspect cases, but had not fulfilled the criteria for a reportable case of pediatric TB. Of these seven newly counted cases, three were detected by ICD-9-CM codes, three by a gastric aspirate log book, and one by both. In contrast, 13 other cases had been reported to the NYC DOH, but were undetected by our alternative surveillance; eight of these could be verified with available medical records. Thus, the demographic and clinical characteristics of the 25 detected and the eight undetected cases with available medical records were evaluated in this study.Conclusions. Alternative surveillance proved effective, was complementary to the NYC DOH surveillance efforts, and increased the number of pediatric TB cases identified during the study period by 21%.

show abstract

“…Rising TB rates among children are windows on increased transmission. 86 In the United States, for example, pediatric TB rates reflected the late 1980s' upsurge in adult rates, 87,88 and were slow to drop even after adult rates declined. 89 Many TB workers have talked of 'sentinel events', 37,38,47 'Geiger counters', 74 and 'litmus tests' 90 when referring to children sick with TB.…”

Section: Children As Sentinels Of Transmission and Policy Responsementioning

confidence: 99%

Commentary: A targets framework: Dismantling the invisibility trap for children with drug-resistant tuberculosis

Becerra

Swaminathan

2014

J Public Health Pol

View full text Add to dashboard Cite

Tuberculosis (TB) is an airborne infectious disease that is both preventable and curable, yet it kills more than a million people every year. Children are highly vulnerable, but often invisible casualties. Drug-resistant forms of TB are on the rise globally, and children are as vulnerable as adults but less likely to be counted as cases of drug-resistant disease if they become sick. Four factors make children with drug-resistant TB 'invisible': first, the nature of the disease in children; second, deficiencies in existing diagnostic tools; third, overreliance on these tools; and fourth, our collective failure to deploy one effective tool for finding and treating children -contact investigation. We describe a nascent science-advocacy network -the Sentinel Project on Pediatric Drug-Resistant Tuberculosis -whose goal is to end child deaths from this disease. Provisional annual targets, focused on children exposed at home to multidrug-resistant TB, to be updated every year, constitute a framework to focus attention and collective actions at the community, national, and global levels. The targets in two age groups, under 5 and 5-14 years old, tell us the number of: (i) children who require complete evaluation for TB disease and infection; (ii) children who require treatment for TB disease; and (iii) children who would benefit from preventive therapy.

show abstract

Epidemiology of tuberculosis among children in the United States: 1985 to 1994

Cited by 72 publications

References 13 publications

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Mycobacterium bovis as a Significant Cause of Tuberculosis in Children Residing Along the United States–Mexico Border in the Baja California Region

Completeness of pediatric TB reporting in New York City

Commentary: A targets framework: Dismantling the invisibility trap for children with drug-resistant tuberculosis

Contact Info

Product

Resources

About