Increasing TB preventive treatment in children

Marais, Barend Jacobus; Bernays, Sarah; Schaaf, H. Simon; Fox, Gregory J.

doi:10.5588/ijtld.22.0288

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…Children have traditionally been considered a lower public health risk for TB because they rarely develop lung cavities and most of them do not produce sputum [13][14][15]. As a result, diagnosing TB in children can be challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Although country-specific statistics are generally unreliable and unpredictable, it is estimated that 10-20% of the global burden of tuberculosis cases affect children under the age of 15 [6,5]. Because they represent a public health risk and the source of MTB transmission, adult pulmonary TB cases with positive sputum smears are the focus of National TB Programs (NTPs) [6], [13][14][15]. Due to their infrequent development of lung cavities and the fact that the majority of them do not generate sputum, children are not typically considered to be a threat to the public's health [13], [21].…”

Section: Introductionmentioning

confidence: 99%

“…Because they represent a public health risk and the source of MTB transmission, adult pulmonary TB cases with positive sputum smears are the focus of National TB Programs (NTPs) [6], [13][14][15]. Due to their infrequent development of lung cavities and the fact that the majority of them do not generate sputum, children are not typically considered to be a threat to the public's health [13], [21].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Tuberculosis in children using Gene Xpert on Gastric lavage samples

Chisompola,

Chanda,

Moono

et al. 2023

Preprint

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Background Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), affects the lungs, kidneys, spine, and brain, has a significant global health challenge affecting 10–20% of children. Zambia is ranked in thirty countries with heavy burden. Early detection and intervention are crucial for managing the disease and preventing its progression to severe forms. Objective The aim of this study was to assess the prevalence of tuberculosis among children aged 0 to 10 years at the Arthur Davison Children's Hospital in Ndola, Zambia. The study specifically focused on children with coughs, and the preferred gastric lavage technique was used for sampling. Methodology: A cross-sectional study was conducted, we enrolled 138 children who were assessed using a structured questionnaire. To diagnosis TB, we employed x-rays and GeneXpert analysis of gastric lavage samples collected from January 2022 to February 2022. Results The results revealed that out of the 138 participants, 119 (86.2%) tested negative for mycobacterium tuberculosis, while 19 (13.8%) tested positive. GeneXpert detected 2 out of the 19 positives (1.4%), whereas chest x-ray identified all 19 positive cases (100%). Males showed a higher prevalence of MTB (52.6%) compared to females (47.4%), and the 0–4 age group had a higher MTB prevalence of 13 cases (68.4%) compared to 6 cases (31.6%) in the 5–10 age group. Conclusion In conclusion, the study showed a low prevalence of MTB (1.4%) in children under 10 years when using GeneXpert with gastric lavage samples. However, chest x-ray outperformed GeneXpert in detecting positive cases. The potential issues with the cumbersome process and the influence of gastric lavage sample acidity raise concerns about GeneXpert's effectiveness as the preferred choice for TB diagnosis in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Tuberculosis in children using Gene Xpert on Gastric lavage samples

Chisompola,

Chanda,

Moono

et al. 2023

Preprint

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“…In addition to PTB, the most frequent presentation, a higher proportion of EPTB form is observed in children TB disease [7]. Notably, due to immature immunological response, infants and young children are more likely to develop severe forms of disseminated TB and TB meningitis [8,9]. Furthermore, children under 5 years old and contact with an index case in household have a relatively high risk of tuberculosis infection, which are at the greatest risk of progressing to active TB [10].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of tuberculosis among children in Beijing, China, 2012–2021

Zheng,

Xiao,

Yang

et al. 2024

Epidemiol. Infect.

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Data on epidemiology trends of paediatric tuberculosis (TB) are limited in China. So, we investigated the clinical and epidemiological profiles in diagnosed TB disease and TB infection patients at Beijing Children's Hospital. Of 3 193 patients, 51.05% had pulmonary TB (PTB) and 15.16% had extrapulmonary TB (EPTB). The most frequent forms of EPTB were TB meningitis (39.05%), pleural TB (29.75%), and disseminated TB (10.33%). PTB patients were significantly younger and associated with higher hospitalization frequency. Children aged 1-4 years exhibited higher risk of PTB and TB meningitis, and children aged 5-12 years had higher risk of EPTB. The proportion of PTB patients increased slightly from 40.9% in 2012 to 65% in 2019, and then decreased to 17.8% in 2021. The percentage of EPTB cases decreased from 18.3% in 2012 to 15.2% in 2019, but increased to 16.4% in 2021. Among EPTB cases, the largest increase was seen in TB meningitis. In conclusion, female and young children had higher risk of PTB in children. TB meningitis was the most frequent forms of EPTB among children, and young children were at high risk of TB meningitis. The distribution of different types of EPTB differed by age.

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“…1 Childhood TB diagnostic challenges are generally due to the poor sensitivity of microbiological diagnostic tests in children, who generally have paucibacillary disease. 2 In addition, microbiological tests are frequently underutilised because of the challenge of obtaining sputum. 3 – 5 Consequently, most children with TB are not microbiologically diagnosed and their diagnosis relies on clinical evaluation and chest X-ray (CXR).…”

mentioning

confidence: 99%

Evaluation of a short training course of chest X-ray interpretation for the diagnosis of paediatric TB

Melingui,

Leroy-Terquem,

Palmer

et al. 2024

IJTLD OPEN

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<sec><title>BACKGROUND</title>Chest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries.</sec><sec><title>METHODS</title>Within the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features. We performed a pre–post training assessment on a pre-defined set of 20 CXR readings. We compared the proportion of correctly interpreted CXRs and the median reading score before and after the training using the McNemar test and a linear mixed model.</sec><sec><title>RESULTS</title>Of 191 HCWs, 43 (23%) were physicians, 103 (54%) nurses, 18 (9.4%) radiology technicians and 12 (6.3%) other professionals. Of 2,840 CXRs with both assessment, respectively 1,843 (64.9%) and 2,277 (80.2%) were correctly interpreted during pre-training and post-training (P < 0.001). The median reading score improved significantly from 13/20 to 16/20 after the training, after adjusting by country, facility and profession (adjusted β = 3.31, 95% CI 2.44–4.47).</sec><sec><title>CONCLUSION</title>Despite some limitations of the course assessment that did not include abnormal non-TB suggestive CXR, study findings suggest that a short CXR training course could improve HCWs’ interpretation skills in diagnosing paediatric TB.</sec>

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Increasing TB preventive treatment in children

Cited by 5 publications

References 25 publications

Prevalence of Tuberculosis in children using Gene Xpert on Gastric lavage samples

Prevalence of Tuberculosis in children using Gene Xpert on Gastric lavage samples

Epidemiology of tuberculosis among children in Beijing, China, 2012–2021

Evaluation of a short training course of chest X-ray interpretation for the diagnosis of paediatric TB

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