A Proposed Comprehensive Classification of Tuberculosis Disease Severity in Children

Wiseman, C. A.; Gie, Robert P.; Starke, Jeffrey R.; Schaaf, H. Simon; Donald, Peter R.; Cotton, Mark F.; Hesseling, Anneke C.

doi:10.1097/inf.0b013e318243e27b

Cited by 88 publications

(70 citation statements)

References 47 publications

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“…The majority (~75%) of disease is intrathoracic, 4 most commonly isolated 5 mediastinal lymph node, Ghon focus or Ghon complex disease. 5 In mid-childhood, mediastinal lymph 6 7 node disease predominates; adult-type disease with pleural effusions and cavitation typically emerges during adolescence. 4,6 The confirmation of TB in children is challenging due to the 8 paucibacillary nature of the disease, challenges in specimen collection and the wide observed 9 disease spectrum.…”

Section: Introductionmentioning

confidence: 99%

“…For example, the 16 yield of mycobacterial culture is considerably higher in children with extensive intrathoracic 17 compared to limited disease. 8 We recently proposed a novel standard approach to describe the 18 spectrum and severity of TB in children 5 which considers both the extent (containment) of disease 19 and the presence of complications; resulting in a final assignation of "severe" or "nonsevere" 20 disease, applicable to both intrathoracic and extrathoracic TB. 5 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Novel application of NIH case definitions in a paediatric tuberculosis contact investigation study

Wiseman¹,

Mandalakas²,

Kirchner³

et al. 2015

int j tuberc lung dis

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201 wordsKey Words: Tuberculosis, paediatric, diagnosis, case definition, NIH Running head title: NIH paediatric TB research definitionSummary: We apply and compare recently proposed International Consensus (NIH) with protocol-specified case definitions for paediatric TB and describe the disease spectrum and severity in a community-based prospective cohort diagnostic TB study using household contact tracing.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel application of NIH case definitions in a paediatric tuberculosis contact investigation study

Wiseman¹,

Mandalakas²,

Kirchner³

et al. 2015

int j tuberc lung dis

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“…BCG vaccination of SIV-infected macaques has previously been shown to exacerbate SIV disease progression and to cause dissemination of M. bovis bacilli (9,35,48). In accordance with a recent proposal to improve the classification of TB disease severity in human children by combining multiple factors ranging from disease pathogenesis criteria to bacteriological evaluation and clinical data (47), vaccine safety in infant macaques was rigorously assessed in the current study by comprehensive clinical examination, histopathological evaluation, and multiple M. tuberculosis culture methods. For safety evaluation, animals were grouped by vaccine strain independent of the route of administration, immunization interval, or prime-boost regimen.…”

Section: Discussionmentioning

confidence: 99%

A Recombinant Attenuated Mycobacterium tuberculosis Vaccine Strain Is Safe in Immunosuppressed Simian Immunodeficiency Virus-Infected Infant Macaques

Jensen

Ranganathan

Rompay

et al. 2012

Clin. Vaccine Immunol.

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ABSTRACTMany resource-poor countries are faced with concurrent epidemics of AIDS and tuberculosis (TB) caused by human immunodeficiency virus (HIV) andMycobacterium tuberculosis, respectively. Dual infections with HIV andM. tuberculosisare especially severe in infants. There is, however, no effective HIV vaccine, and the only licensed TB vaccine, theMycobacterium bovisbacillus Calmette-Guérin (BCG) vaccine, can cause disseminated mycobacterial disease in HIV-infected children. Thus, a pediatric vaccine to prevent HIV andM. tuberculosisinfections is urgently needed. We hypothesized that a highly attenuatedM. tuberculosisstrain containing HIV antigens could be safely administered at birth and induce mucosal and systemic immune responses to protect against HIV and TB infections, and we rationalized that vaccine safety could be most rigorously assessed in immunocompromised hosts. Of three vaccine candidates tested, the recombinant attenuatedM. tuberculosisstrain mc26435 carrying a simian immunodeficiency virus (SIV) Gag expression plasmid and harboring attenuations of genes critical for replication (panCDandleuCD) and immune evasion (secA2), was found to be safe for oral or intradermal administration to non-SIV-infected and SIV-infected infant macaques. Safety was defined as the absence of clinical symptoms, a lack of histopathological changes indicative ofM. tuberculosisinfection, and a lack of mycobacterial dissemination. These data represent an important step in the development of novel TB vaccines and suggest that a combination recombinant attenuatedM. tuberculosis-HIV vaccine could be a safe alternative to BCG for the pediatric population as a whole and, more importantly, for the extreme at-risk group of HIV-infected infants.

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“…Childhood tuberculosis commonly extrapulmonary, disseminated, and severe, especially in children under 3 years of age, and it is associated with high morbidity and mortality [1]. Some authors [17] propose comprehensive disease classification systems in order to reflect the clinical TB disease spectrum in children although they are not widely used.…”

Section: Clinical Findingsmentioning

confidence: 99%

Clinical, Radiological and Inmunological Features in Children with Pulmonary Tuberculosis: A Review

J¹

2014

J Mycobac Dis

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In the whole world, tuberculosis (TB) continues being an important health problem. It produces a great number of deaths in children, mainly in the wake of the HIV epidemic. In addition, the globalization with the increased of the international travels and the immigration makes that TB control be more difficult. This is a clinical, radiological and immunological review in children TB where we search to contribute the data in the literature. ContextTuberculosis (TB) is one of the most important global health problems. The latest estimates included in the Global tuberculosis report are that there were 8.6 million new TB cases in 2012 and 1.3 million TB deaths worldwide. Of those, 530.000 cases and 74.000 deaths were children [1]. Clinical and radiological findings, such as hemoptisis, cough, caverns or upper-lobe condensations, might be reliable and well established in adults. By contrast, these findings might be more difficult to evaluate in children due to more nonspecific symptoms and heterogeneus radiological findings [2]. ObjectiveThe present work overviews the most important clinical and radiological findings in children diagnosed with tuberculosis infection and disease. We included articles that reported cases with children from 2 months to 13 years. Children were from different backgrounds, and from developed and underdeveloped countries. Data SourcesThe selection of studies for analysis was as follows: all articles published from October 2008 to December 2013, which described clinical and radiological findings of children with TB were selected. These articles were obtained by searching throughout several international databases including Pubmed, Scopus, Highwire Press, Scientific Information Databases, Google Scholar and EBSCO-host.To locate the articles to include in our review, the strategy consisted of an exhaustive search including the following medical subject headings (MeSH) terms: "tuberculosis" or "pulmonary tuberculosis" in combination with "children" or "infant" or "infancy", in combination with "clinical symptoms", "radiological findings", "Mantoux", "tuberculosis diagnosis", "management of tuberculosis" and "tuberculosis treatment". Study SelectionInclusion criteria for systematic review were: 1) Retrospective or prospective cohort studies; 2) Reporting clinical, radiological or Mantoux results in TB patients 3) Studies including data at the national level; and 4) Studies on TB patients meeting either the WHO recommended definitions for "definite cases" or "other than definite cases" or TB patients meeting the possible, probable or confirmed case definition as published by the European Commission in 2008.Opinion articles, editorials, comments, case studies and/or drug efficacy tested in vitro or through clinical trials were excluded from the systematic review. Furthermore, those articles not published in English or Spanish language were excluded from the review. Literature searching was performed until 1 st December 2013. Using the search terms previously described above, fifty-three st...

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A Proposed Comprehensive Classification of Tuberculosis Disease Severity in Children

Cited by 88 publications

References 47 publications

Novel application of NIH case definitions in a paediatric tuberculosis contact investigation study

Novel application of NIH case definitions in a paediatric tuberculosis contact investigation study

A Recombinant Attenuated Mycobacterium tuberculosis Vaccine Strain Is Safe in Immunosuppressed Simian Immunodeficiency Virus-Infected Infant Macaques

Clinical, Radiological and Inmunological Features in Children with Pulmonary Tuberculosis: A Review

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