Risk of developing active TB in children with latent TB infection

Корнева, Н. В.; Старшинова, Анна; Ananiev, S.; Ovchinnikova, Yulia; Dovgaluk, Irina; Yablonskii, Piotr

doi:10.1183/13993003.congress-2015.pa2976

Cited by 1 publication

(1 citation statement)

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“…28 Using chest radiograph as a gold standard, authors devised a score based on cough and reduced playfulness that could identify child contacts with high probability of having TB disease, enabling them to differentiate these patients from paediatric patients with TB infection or no TB infection following exposure to infected adults. [87][88][89][90][91][92][93][94][95][96][97][98][99][100] Only one study documented <90% recommendation rate: a study from Australia in which 86% of paediatric patients with TB infection were recommended to start treatment. 101 The primary reason treatment was not recommended in high-income countries and LMIC was because providing treatment was not strictly indicated, for example, because of guidelines not supporting TB infection treatment for select patients with positive tests 37 87 and presumed falsepositive tests in the setting of prior BCG vaccination.…”

Section: Bmj Global Healthmentioning

confidence: 99%

A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking

2021

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Background and objectivesIdentifying and treating children with latent tuberculosis infection (TB infection) is critical to prevent progression to TB disease and to eliminate TB globally. Diagnosis and treatment of TB infection requires completion of a sequence of steps, collectively termed the TB infection care cascade. There has been no systematic attempt to comprehensively summarise literature on the paediatric TB infection care cascade.MethodsWe performed a scoping review of the paediatric TB infection care cascade. We systematically searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane and Embase databases. We reviewed articles and meeting abstracts that included children and adolescents ≤21 years old who were screened for or diagnosed with TB infection, and which described completion of at least one step of the cascade. We synthesised studies to identify facilitators and barriers to retention, interventions to mitigate attrition and knowledge gaps.ResultsWe identified 146 studies examining steps in the paediatric TB infection care cascade; 31 included children living in low-income and middle-income countries. Most literature described the final cascade step (treatment initiation to completion). Studies identified an array of patient and caregiver-related factors associated with completion of cascade steps. Few health systems factors were evaluated as potential predictors of completion, and few interventions to improve retention were specifically tested.ConclusionsWe identified strengths and gaps in the literature describing the paediatric TB infection care cascade. Future research should examine cascade steps upstream of treatment initiation and focus on identification and testing of at-risk paediatric patients. Additionally, future studies should focus on modifiable health systems factors associated with attrition and may benefit from use of behavioural theory and implementation science methods to improve retention.

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