Pediatric and Adolescent Tuberculosis in the United States, 2008–2010

Winston, Carla A.; Menzies, Heather

doi:10.1542/peds.2012-1057

Cited by 76 publications

(64 citation statements)

References 24 publications

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“…This is much higher than reported in the EU/EEA as a whole (29.2%) [7]. In line with previous data from lowincidence settings [4][5][6]16], this is an extremely high incidence rate for foreign-born children considering that most incident cases are found several or even many years after arrival in Denmark [17]. This is especially true for Somali children.…”

Section: Discussionsupporting

confidence: 84%

A review of paediatric tuberculosis in Denmark: 10-year trend, 2000–2009

et al. 2013

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Paediatric tuberculosis (TB) is a key indicator for recent transmission and presents a reservoir for the disease. We describe trends in epidemiology, microbiological characteristics and treatment outcome in Denmark between 2000 and 2009. Data were retrieved from the national TB surveillance system and the International Reference Laboratory of Mycobacteriology.In total, 323 TB cases were reported in children aged ,15 years, accounting for 7.6% of all notified cases in Denmark. The overall incidence rate of childhood TB declined from 4.1 per 100 000 to 1.9 per 100 000 in the study period. Immigrant children comprised 79.6% of all cases, with the highest incidence rate of 94.1 per 100 000 children in 2001. In contrast to immigrant children, the majority of Danish children were aged ,5 years and had a known exposure to TB. Pulmonary TB was the commonest presentation. Only half of the cases were culture confirmed.We observed an overall decreasing trend in the child to adult notification ratio, but a slight increase in the ratio when calculated specifically for ethnic Danes.Childhood TB needs continuous attention with a special focus on risk groups. Emphasis on improving early TB case detection, contact tracing and further implementation of preventive treatment is necessary. @ERSpublications Childhood TB needs continuous attention with a special focus on risk groups

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Section: Discussionsupporting

confidence: 84%

A review of paediatric tuberculosis in Denmark: 10-year trend, 2000–2009

et al. 2013

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“…The Hispanic predominance was consistent with other California studies 3,6 but was higher than in the United States overall (39% to 66%). 2,20,21 The predominance of US birth has been noted, albeit to a lesser extent, in other US and California studies. However, a higher percentage of US-born children in our cohort had a foreign-born parent compared with other pediatric TB studies in the United States (64% to 68%), 6,20,21 possibly reflecting an increase in the foreign-born population in California since those studies were conducted.…”

Section: Discussionmentioning

confidence: 81%

Risk Factors for Central Nervous System Tuberculosis

et al. 2015

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OBJECTIVES: To describe the epidemiology and factors associated with pediatric central nervous system (CNS) tuberculosis (TB) in California from 1993 to 2011. METHODS:We analyzed California TB registry data for persons aged #18 years, comparing CNS TB cases versus non-CNS TB cases reported from 1993 to 2011. Factors associated with CNS TB and TB deaths were identified by using multivariate logistic regression.RESULTS: A total of 200 CNS TB cases were reported. Compared with non-CNS TB case patients, CNS TB case patients were more likely to be aged ,5 years (72.0% vs 43.6%; odds ratio [OR] CONCLUSIONS: Subsets of children are at increased risk for CNS TB in California and may benefit from additional prevention efforts. WHAT'S KNOWN ON THIS SUBJECT:Central nervous system (CNS) tuberculosis has high morbidity and mortality, and it frequently affects children aged ,5 years. WHAT THIS STUDY ADDS:In California, children who were US-born, Hispanic, and aged ,5 years were at increased risk of CNS tuberculosis. Children with CNS tuberculosis were more likely to die. Specific populations of US-born infants might benefit from additional prevention measures. Dr Duque-Silva was involved in research design, performed the data analysis and interpretation, and drafted and revised the manuscript; Ms Robsky was involved in research design and assisted with data analysis and interpretation; and Dr Flood assisted in research design and data interpretation, and reviewed and revised the manuscript. Dr Barry conceptualized the study; supervised the research design, data analysis, and interpretation; and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted. 2,3 It is most commonly diagnosed in children aged ,5 years and may affect the same groups at high risk for pediatric TB in the United States such as immigrants, racial and ethnic minorities, and children who traveled to a country with high prevalence of TB or who had contact with a household visitor from a high-prevalence country. [4][5][6] In children, CNS TB is often the result of recently acquired infection after close contact with an infectious TB case in an adult. Risk of dissemination to the CNS after TB exposure is influenced by age and immune status, 7 including BCG vaccination. In most countries outside the United States, BCG vaccination is recommended in early childhood to decrease the risk of disseminated forms of TB such as miliary and CNS TB in children. 8 BCG vaccination has not routinely been used in the United States. 9 California is the state that reports the most pediatric TB cases 10 and has the largest foreign-born population in the United States. 11 It is therefore an excellent population in which to examine the epidemiology of pediatric CNS TB. To inform ongoing CNS TB prevention activities, our goal was to describe the epidemiology of pediatric CNS TB in California from 1993 to 2011 and to identify factors associated with the development of pediatric CNS TB as well as factors associated with pedia...

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“…1 Of the 2660 children and adolescents younger than 18 years with TB disease reported in the United States from 2008 to 2010, 31% were born in other countries. 2 Among the US-born pediatric patients, 66% had at least 1 foreign-born parent, and 75% of all the pediatric patients had some international connection through family or residence history. Although 52% of these cases occurred in children ages 13 to 17 years, infants and young children have the highest rate of TB infection progressing to TB disease rapidly after exposure (ie, within a few weeks to several months).…”

Section: Introductionmentioning

confidence: 99%

Interferon-γ Release Assays for Diagnosis of Tuberculosis Infection and Disease in Children

Starke¹,

Byington²,

Barnett³

et al. 2014

Pediatrics

143

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Tuberculosis (TB) remains an important problem among children in the United States and throughout the world. Although diagnosis and treatment of infection with Mycobacterium tuberculosis (also referred to as latent tuberculosis infection [LTBI] or TB infection) remain the lynchpins of TB prevention, there is no diagnostic reference standard for LTBI. The tuberculin skin test (TST) has many limitations, including difficulty in administration and interpretation, the need for a return visit by the patient, and false-positive results caused by significant cross-reaction with Mycobacterium bovis-bacille CalmetteGuérin (BCG) vaccines and many nontuberculous mycobacteria. Interferon-γ release assays (IGRAs) are blood tests that measure ex vivo T-lymphocyte release of interferon-γ after stimulation by antigens specific for M tuberculosis. Because these antigens are not found on M bovis-BCG or most nontuberculous mycobacteria, IGRAs are more specific tests than the TST, yielding fewer false-positive results. However, IGRAs have little advantage over the TST in sensitivity, and both methods have reduced sensitivity in immunocompromised children, including children with severe TB disease. Both methods have a higher positive predictive value when applied to children with risk factors for LTBI. Unfortunately, neither method distinguishes between TB infection and TB disease. The objective of this technical report is to review what IGRAs are most useful for: (1) increasing test specificity in children who have received a BCG vaccine and may have a falsepositive TST result; (2) using with the TST to increase sensitivity for finding LTBI in patients at high risk of developing progression from LTBI to disease; and (3) helping to diagnose TB disease. Pediatrics

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Pediatric and Adolescent Tuberculosis in the United States, 2008–2010

Cited by 76 publications

References 24 publications

A review of paediatric tuberculosis in Denmark: 10-year trend, 2000–2009

A review of paediatric tuberculosis in Denmark: 10-year trend, 2000–2009

Risk Factors for Central Nervous System Tuberculosis

Interferon-γ Release Assays for Diagnosis of Tuberculosis Infection and Disease in Children

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