Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG?

Gwee, Amanda; Rodrigo, Ranmali; Casalaz, Dan; Ritz, Nicole; Curtis, Nigel

doi:10.5694/mja13.10107

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…Parental awareness of the need for pre-travel health assessment may be low in the immigrant population. In a study of Australian postpartum mothers originating from high tuberculosis prevalence countries, of those planning to return with their child to their country of birth, only 10% were aware of BCG vaccination recommendations [46]. Further, of immigrant participants, 24% were recent immigrants, arriving within the past 5 years.…”

Section: Discussionmentioning

confidence: 99%

The contribution of travellers visiting friends and relatives to notified infectious diseases in Australia: state-based enhanced surveillance

et al. 2016

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SUMMARYImmigrants and their children who return to their country of origin to visit friends and relatives (VFR) are at increased risk of acquiring infectious diseases compared to other travellers. VFR travel is an important disease control issue, as one quarter of Australia's population are foreign-born and one quarter of departing Australian international travellers are visiting friends and relatives. We conducted a 1-year prospective enhanced surveillance study in New South Wales and Victoria, Australia to determine the contribution of VFR travel to notifiable diseases associated with travel, including typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya. Additional data on characteristics of international travel were collected. Recent international travel was reported by 180/222 (81%) enhanced surveillance cases, including all malaria, chikungunya and paratyphoid cases. The majority of cases who acquired infections during travel were immigrant Australians (96, 53%) or their Australian-born children (43, 24%). VFR travel was reported by 117 (65%) travel-associated cases, highest for typhoid (31/32, 97%). Cases of children (aged <18 years) (86%) were more frequently VFR travellers compared to adult travellers (57%, P < 0·001). VFR travel is an important contributor to imported disease in Australia. Communicable disease control strategies targeting these travellers, such as targeted health promotion, are likely to impact importation of these travel-related infections.

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Section: Discussionmentioning

confidence: 99%

The contribution of travellers visiting friends and relatives to notified infectious diseases in Australia: state-based enhanced surveillance

et al. 2016

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“…21 BCG vaccination should be actively promoted for these children. 22 Although false-positive TST results are possible in those who are BCG vaccinated, the IGRA test still provides a specific result in people who have received BCG vaccination. 23 Given the relative infrequency of childhood TB, and the complexities of diagnosis and management, we have initiated a multidisciplinary meeting within the SCHN for detailed case review.…”

Section: Discussionmentioning

confidence: 99%

Overview of paediatric tuberculosis cases treated in the Sydney Children’s Hospitals Network, Australia

Yazidi

Marais

Wickens

et al. 2019

Public Health Res Pract

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Background: Sydney has a large and highly mobile immigrant community. The pattern of paediatric tuberculosis (TB) disease in this highly cosmopolitan city is not well documented. Methods: We reviewed data on all children notified with TB in New South Wales (NSW), Australia, from January 2014 to December 2015, complemented by an expanded dataset for children managed within the Sydney Children's Hospitals Network (SCHN). Results: Over the 2-year study period, 921 TB cases were identified in NSW, including 26 (2.8%) children younger than 15 years of age. Of 23 children and adolescents treated for TB in the SCHN, 21 (91.3%) had a history of recent immigration from, or travel to, a country with high TB incidence, and 7 (30.4%) reported contact with an infectious TB case in Australia. Fourteen (60.9%) children had microbiologically confirmed TB; of these, 5 (21.7%) had acid-fast bacilli on microscopy, 8 (34.8%) were positive by polymerase chain reaction and 11 (47.8%) were positive by culture. All Mycobacterium tuberculosis isolates were susceptible to first-line drugs. Ten (43.5%) cases were not vaccinated with bacille Calmette-Guérin (BCG), including all cases with severe disease: 2 with disseminated (miliary) TB and 3 with tuberculous meningitis. Conclusion: Our findings emphasise the need for improved TB prevention and surveillance in children at high risk of exposure, particularly young children travelling to areas of high TB incidence.

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“…Immigrant families in Western Sydney regularly travel to high TB incidence countries to visit friends and relatives, which place young children at risk of TB exposure, infection and disease, especially if they are not Bacille Calmette–Guérin (BCG) vaccinated [45]. Ideally, BCG vaccination should be offered at birth to immigrant families or be readily available as a travel vaccine in these vulnerable young children [45, 46].…”

Section: Discussionmentioning

confidence: 99%

Detailed characterisation of the tuberculosis epidemic in Western Sydney: a descriptive epidemiological study

et al. 2019

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Traditional tuberculosis (TB) epidemiology reports rarely provide a detailed analysis of TB incidence in particular geographic locations and among diverse population groups. Western Sydney Local Health District (WSLHD) has one of the highest TB incidence rates in Australia, and we explored whether more detailed epidemiological analysis could provide a better overview of the local disease dynamics.Using multiple relevant data sources, we performed a retrospective descriptive study of TB cases diagnosed within the WSLHD from 2006 to 2015 with a specific focus on geographic hotspots and the population structure within these hotspots.Over the study period nearly 90% of Western Sydney TB cases were born in a high TB incidence country. The TB disease burden was geographically concentrated in particular areas, with variable ethnic profiles in these different hotspots. The most common countries of birth were India (33.0%), the Philippines (11.4%) and China (8.8%). Among the local government areas in Western Sydney, Auburn had the highest average TB incidence (29.4 per 100 000) with exceptionally high population-specific TB incidence rates among people born in Nepal (average 223 per 100 000 population), Afghanistan (average 154 per 100 000 population) and India (average 143 per 100 000 population).Similar to other highly cosmopolitan cities around the world, the TB burden in Sydney showed strong geographic concentration. Detailed analysis of TB patient and population profiles in Western Sydney should guide better contextualised and culturally appropriate public health strategies.

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Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG?

Cited by 6 publications

References 5 publications

The contribution of travellers visiting friends and relatives to notified infectious diseases in Australia: state-based enhanced surveillance

The contribution of travellers visiting friends and relatives to notified infectious diseases in Australia: state-based enhanced surveillance

Overview of paediatric tuberculosis cases treated in the Sydney Children’s Hospitals Network, Australia

Detailed characterisation of the tuberculosis epidemic in Western Sydney: a descriptive epidemiological study

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