Isolation of Nontuberculous Mycobacteria in Southeast Asian and African Human Immunodeficiency Virus–infected Children With Suspected Tuberculosis

Borand, Laurence; Lauzanne, Agathe de; Nguyen, Ngoc Lan; Cheng, Sokleaph; Pham, Thu Hang; Eyangoh, Sara; Ouédraogo, Abdoul–Salam; Vibol, Ung; Msellati, Philippe; Tejiokem, Mathurin Cyrille; Nacro, Boubacar; Inghammar, Malin; Dim, Bunnet; Delacourt, Christophe; Godreuil, Sylvain; Blanche, Stéphane; Marcy, Olivier

doi:10.1093/cid/ciy897

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…No estimates exist for the incidence of clinical syndromes caused by NTM in children or adults, and the available data is usually a by-product of studies assessing the burden of pulmonary TB in children, from whom NTM were isolated from respiratory specimens. The rate of NTM isolation in high TB burden settings varies between countries; from 2.7–26.3%, and increasing age is associated with a higher proportion (167–170). Mycobacterium avium complex species, M. fortuitum, scrofulaceum , and gordonae , are among the most frequently identified NTM in these studies.…”

Section: Non-tuberculous Mycobacteriamentioning

confidence: 99%

“…Although concurrent TB and NTM is thought to be common, only a few reports have addressed this issue, (171–174) and the prevalence of co-infection depends on the sensitivity of the assay in detecting multiple species. In a recent study of HIV-infected children from African and South East Asian settings, NTM was isolated in 46/427(10.8%) of children, including 5 (1.2%) with both NTM and M. tuberculosis (170).…”

Section: Non-tuberculous Mycobacteriamentioning

confidence: 99%

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Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

et al. 2019

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Millions of children are exposed to tuberculosis (TB) each year, many of which become infected with Mycobacterium tuberculosis . Most children can immunologically contain or eradicate the organism without pathology developing. However, in a minority, the organism overcomes the immunological constraints, proliferates and causes TB disease. Each year a million children develop TB disease, with a quarter dying. While it is known that young children and those with immunodeficiencies are at increased risk of progression from TB infection to TB disease, our understanding of risk factors for this transition is limited. The most immunologically disruptive process that can happen during childhood is infection with another pathogen and yet the impact of co-infections on TB risk is poorly investigated. Many diseases have overlapping geographical distributions to TB and affect similar patient populations. It is therefore likely that infection with viruses, bacteria, fungi and protozoa may impact on the risk of developing TB disease following exposure and infection, although disentangling correlation and causation is challenging. As vaccinations also disrupt immunological pathways, these may also impact on TB risk. In this article we describe the pediatric immune response to M. tuberculosis and then review the existing evidence of the impact of co-infection with other pathogens, as well as vaccination, on the host response to M. tuberculosis . We focus on the impact of other organisms on the risk of TB disease in children, in particularly evaluating if co-infections drive host immune responses in an age-dependent way. We finally propose priorities for future research in this field. An improved understanding of the impact of co-infections on TB could assist in TB control strategies, vaccine development (for TB vaccines or vaccines for other organisms), TB treatment approaches and TB diagnostics.

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Section: Non-tuberculous Mycobacteriamentioning

confidence: 99%

Section: Non-tuberculous Mycobacteriamentioning

confidence: 99%

Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

et al. 2019

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“…43 The lower score specificity in Cambodia could be due to higher rates of nontuberculous mycobacteria disease, which is difficult to distinguish from tuberculosis. 44…”

Section: Figurementioning

confidence: 99%

A Treatment-Decision Score for HIV-Infected Children With Suspected Tuberculosis

et al. 2019

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BACKGROUND: Diagnosis of tuberculosis should be improved in children infected with HIV to reduce mortality. We developed prediction scores to guide antituberculosis treatment decision in HIV-infected children with suspected tuberculosis. METHODS: HIV-infected children with suspected tuberculosis enrolled in Burkina Faso, Cambodia, Cameroon, and Vietnam (ANRS 12229 PAANTHER 01 Study), underwent clinical assessment, chest radiography, Quantiferon Gold In-Tube (QFT), abdominal ultrasonography, and sample collection for microbiology, including Xpert MTB/RIF (Xpert). We developed 4 tuberculosis diagnostic models using logistic regression: (1) all predictors included, (2) QFT excluded, (3) ultrasonography excluded, and (4) QFT and ultrasonography excluded. We internally validated the models using resampling. We built a score on the basis of the model with the best area under the receiver operating characteristic curve and parsimony. RESULTS: A total of 438 children were enrolled in the study; 251 (57.3%) had tuberculosis, including 55 (12.6%) with culture- or Xpert-confirmed tuberculosis. The final 4 models included Xpert, fever lasting >2 weeks, unremitting cough, hemoptysis and weight loss in the past 4 weeks, contact with a patient with smear-positive tuberculosis, tachycardia, miliary tuberculosis, alveolar opacities, and lymph nodes on the chest radiograph, together with abdominal lymph nodes on the ultrasound and QFT results. The areas under the receiver operating characteristic curves were 0.866, 0.861, 0.850, and 0.846, for models 1, 2, 3, and 4, respectively. The score developed on model 2 had a sensitivity of 88.6% and a specificity of 61.2% for a tuberculosis diagnosis. CONCLUSIONS: Our score had a good diagnostic performance. Used in an algorithm, it should enable prompt treatment decision in children with suspected tuberculosis and a high mortality risk, thus contributing to significant public health benefits.

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“…30 A higherthan-expected prevalence of NTM currently challenges TB diagnosis in many countries of the meningitis belt. 31,32 PILD in humans and animals caused by NTM is widely reported in sub-Saharan Africa. 33−35 The dispersal of mycobacteria including MTBC and NTM among humans, livestock, and wildlife points to the potential to cause large epidemics in the belt.…”

Section: ■ Evolution Of Meningitis Pathogens and Laboratory Diagnosti...mentioning

confidence: 99%

Optimizing Laboratory Diagnostic Services for Infectious Meningitis in the Meningitis Belt of sub-Saharan Africa

Okolie

Essien

2019

ACS Infect. Dis.

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For longer than a century, the “meningitis belt” of sub-Saharan Africa has experienced the largest-ever global meningitis epidemic. Whereas HIV-associated immunosuppression drives higher susceptibility to environmental infectious organisms with tropism for the central nervous system (CNS), most diagnostic laboratories in the belt stick to N. meningitidis, H. influenzae, and S. pneumoniae. Cryptococcus neoformans has been the leading cause of death (incidence, 89%; death, 75%). To establish whether diagnostic services target geographically important pathogens, there is a need to know the current spectrum of etiology. Given Africa’s agro-silvo-pastoralism, the One Health diagnostic approach is recommended. Considering multipathogen detection capacity, needed speed for corticosteroid therapy decision, and susceptibility/resistance to antimicrobials with improved CNS penetration, proposed laboratory categorization will help neurologists to choose suitable services.

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Isolation of Nontuberculous Mycobacteria in Southeast Asian and African Human Immunodeficiency Virus–infected Children With Suspected Tuberculosis

Cited by 7 publications

References 12 publications

Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

A Treatment-Decision Score for HIV-Infected Children With Suspected Tuberculosis

Optimizing Laboratory Diagnostic Services for Infectious Meningitis in the Meningitis Belt of sub-Saharan Africa

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