Adolescent tuberculosis: A challenge and opportunity to prevent community transmission

Margarit, Adriana; Simó, Sergi; Rozas, Librada; Deyà‐Martínez, Àngela; Barrabeig, Irene; Gené, Amadeu; Fortuny, Clàudia; Noguera-Julián, Antoni

doi:10.1016/j.anpede.2016.03.007

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Our study revealed a slight male preponderance in the prevalence of TB cases seen over the study period, supporting the declaration of the World Health Organisation that males are more predisposed to contracting TB compared to females [18]. This finding also corroborates the reports of three previous studies which found a male preponderance amongst patients with TB However, it contrasts with the report of one study which found more females with TB than males, though this particular study only involved adolescents 12 -18 years [22]. The possible explanation for the observed male preponderance has been linked to biological differences between males and females in certain age groups that affect the risk of being infected as well as the risk of progression to Childhood TB is said to occur most commonly among infants and young children under five years of age due to their relatively reduced immunity which enhances their early progression from TB infection to TB disease [8].…”

Section: Discussionsupporting

confidence: 87%

Pattern and Outcome of Childhood Tuberculosis Seen at the University of Port Harcourt Teaching Hospital, Nigeria

Alex-Hart¹,

Paul²

2019

JTR

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Background: Despite the fact that Tuberculosis (TB) is preventable, treatable and curable, it has remained a significant cause of childhood morbidity and mortality. Identifying patterns of TB and its treatment outcome which is the aim of this study is relevant for TB control programmes. Methodology: This was a retrospective cross-sectional study carried out over a three-month period from April-June 2019 at the directly observed treatment Short course (DOTS) clinic of the

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Section: Discussionsupporting

confidence: 87%

Pattern and Outcome of Childhood Tuberculosis Seen at the University of Port Harcourt Teaching Hospital, Nigeria

Alex-Hart¹,

Paul²

2019

JTR

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“…The consequences of inadequate and incomplete TB treatment are serious: prolonged illness and disability for the patient, infectiousness of the patient causing continued TB transmission in the community, development of drug resistant TB, and the possibility of death [3]. Considering adult-type pulmonary TB (PTB) is common among adolescents and is often diagnosed late, adolescents can pose a significant transmission risk to the community [12].…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa

et al. 2019

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Background Gauteng Province has the second lowest tuberculosis (TB) incidence rate in South Africa but the greatest proportion of TB/HIV co-infection, with 68% of TB patients estimated to have HIV. TB treatment outcomes are well documented at the national and provincial level; however, knowledge gaps remain on how outcomes differ across detailed age groups. Methods Using data from South Africa’s National Electronic TB Register (ETR), we assessed all-cause mortality and loss to follow-up (LTFU) among patients initiating treatment for TB between 01/2010 and 12/2015 in the metropolitan municipalities of Ekurhuleni Metropolitan Municipality and the City of Johannesburg in Gauteng Province. We excluded patients who were missing age, had known drug-resistance, or transferred into TB care from sites outside the two metropolitan municipalities. Among patients assigned a treatment outcome, we investigated the association between age group at treatment initiation and mortality or LTFU (treatment interruption of ≥2 months) within 10 months after treatment initiation using Cox proportional hazard models and present hazard ratios and Kaplan-Meier survival curves. Results We identified 182,890 children (<10 years), young adolescent (10–14), older adolescent (15–19), young adult (20–24), adult (25–49), and older adult (≥50) TB cases without known drug-resistance. ART coverage among HIV co-infected patients was highest for young adolescents (64.3%) and lowest for young adults (54.0%) compared to other age groups (all over 60%). Treatment success exceeded 80% in all age groups ( n = 170,017). All-cause mortality increased with age. Compared to adults, young adults had an increased hazard of LTFU (20–24 vs 25–49 years; aHR 1.43 95% CI: 1.33, 1.54) while children, young adolescents, and older adults had lower hazard of LTFU. Patients with HIV on ART had a lower risk of LTFU, but greater risk of death when compared to patients without HIV. Conclusions Young adults in urban areas of Gauteng Province experience a disproportionate burden of LTFU and low coverage of ART among co-infected patients. This group should be targeted for interventions aimed at improving clinical outcomes and retention in both TB and HIV care.

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“…Este es el primer estudio en reportar las características epidemiológicas y el resultado del tratamiento en adolescentes de 10 a 14 años con diagnóstico de TB. En este grupo la enfermedad se caracteriza por ser predominantemente pulmonar (6,33) y esto podría incrementar la oportunidad de propagación en entornos escolares hasta 21 veces más (OR: 22,5, IC95%: 5,9-191,4) (34). El éxito en el tratamiento es superior a lo esperado, con bajo porcentaje de pérdidas en el seguimiento, que podría mejorarse desarrollando servicios de salud para adolescentes que incluyan apoyo psicosocial y una interrupción mínima de la educación.…”

Section: Discussionunclassified

Tuberculosis en niños y adolescentes en Ecuador: análisis de la notificación, las características de la enfermedad y el resultado del tratamiento

Silva

Pérez

Marín

2019

Revista Panamericana De Salud Pública

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Objetivos. Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador. Métodos. Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años. Resultados. De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%). Conclusiones: Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.

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Adolescent tuberculosis: A challenge and opportunity to prevent community transmission

Cited by 7 publications

References 11 publications

Pattern and Outcome of Childhood Tuberculosis Seen at the University of Port Harcourt Teaching Hospital, Nigeria

Pattern and Outcome of Childhood Tuberculosis Seen at the University of Port Harcourt Teaching Hospital, Nigeria

Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa

Tuberculosis en niños y adolescentes en Ecuador: análisis de la notificación, las características de la enfermedad y el resultado del tratamiento

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