Contact tracing of a 15-year-old girl with smearnegative pulmonary tuberculosis in Tehran

Baghaie, Noshin; Khalilzadeh, Soheila; Mr, Bolursaz; Parsanejad, Nazanin

doi:10.26719/2012.18.4.399

Cited by 9 publications

(5 citation statements)

References 12 publications

(16 reference statements)

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“…Only few, highly variable and conflicting data are available concerning transmission by pediatric source cases, all of which come from individual case reports: the rate of transmission when a child or adolescent has microscopic positive expectorate or gastric aspirate ranges from 0.5 to 39.3% [5], whereas the only two reported cases of children with microscopic negative expectorate/gastric aspirate transmitted TB to 29.8 [9] and 72.4% [10] of their contacts. However, the exiguous number of described cases and the lack of information concerning the presence of other risk factors for the acquisition of TB in the contacts does not allow any conclusions to be drawn concerning the real rate of transmission when the source case is a child.…”

Section: Introductionmentioning

confidence: 99%

How to manage children who have come into contact with patients affected by tuberculosis

Lancella

Vecchio²,

Chiappini

et al. 2015

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Childhood tuberculosis (TB) indicates a recent infection, particularly in children aged < 5 years, and therefore is considered a sentinel event insofar as it highlights the presence of an undiagnosed or untreated source case. The risk of acquiring TB is directly proportional to the number of bacilli to which a subject is exposed and the environment in which the contact occurred. This document contains the recommendations of a group of Italian scientific societies for managing a child exposed to a case of TB based on an analysis of the risk factors for acquiring latent tuberculous infection (LTBI) and developing the disease, and the particular aspects TB transmission during the first years of life. The guidance includes a detailed description of the methods used to identify the index case, the tests that the exposed child should receive and the possibilities of preventive chemoprophylaxis depending on the patient's age and immune status, the chemotherapy and monitoring methods indicated in the case of LTBI, the management of a child who has come into contact with a case of multidrug-resistant or extensively drug-resistant TB, and the use of molecular typing in the analysis of epidemics. The group of experts identified risk factors for tuberculous infection and disease in pediatric age as well as gave recommendation on management of contacts of cases of TB according to their age, risk factors and exposure to multidrug-resistant or extensively drug-resistant TB.

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Section: Introductionmentioning

confidence: 99%

How to manage children who have come into contact with patients affected by tuberculosis

Lancella

Vecchio²,

Chiappini

et al. 2015

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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“…The primary characteristics of the studies included in the review are summarized in Table 1. In total, 28 studies with 54,707 school contacts were included in the pooled prevalence of M. tuberculosis infection, of which 19 studies were from China, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] three were from Italy, [32][33][34] two were from Korea, 35,36 and four studies each were from Iran, 37 Japan, 38 Sweden, 39 and the United States, 40 respectively. In regard to study design, 15 were cross-sectional studies and 11 were retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

Mycobacterium tuberculosis Infection in School Contacts of Tuberculosis Cases: A Systematic Review and Meta-Analysis

Wang,

Liu,

Liu

et al. 2024

The American Journal of Tropical Medicine and Hygiene

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Substantial tuberculosis transmission occurs outside of households, and tuberculosis surveillance in schools has recently been proposed. However, the yield of tuberculosis outcomes from school contacts is not well characterized. We assessed the prevalence of Mycobacterium tuberculosis infection among close school contacts by performing a systematic review. We searched PubMed, Elsevier, China National Knowledge Infrastructure, and Wanfang databases. Studies reporting the number of children who were tested overall and who tested positive were included. Subgroup analyses were performed by study location, index case bacteriological status, type of school, and other relevant factors. In total, 28 studies including 54,707 school contacts screened for M. tuberculosis infection were eligible and included in the analysis. Overall, the prevalence of M. tuberculosis infection determined by the QuantiFERON Gold in-tube test was 33.2% (95% CI, 0.0–73.0%). The prevalences of M. tuberculosis infection based on the tuberculin skin test (TST) using 5 mm, 10 mm, and 15 mm as cutoffs were 27.2% (95% CI, 15.1–39.3%), 24.3% (95% CI, 15.3–33.4%), and 12.7% (95% CI, 6.3–19.0%), respectively. The pooled prevalence of M. tuberculosis infection (using a TST ≥5-mm cutoff) was lower in studies from China (22.8%; 95% CI, 16.8–28.8%) than other regions (36.7%; 95% CI, 18.1–55.2%). The pooled prevalence of M. tuberculosis infection was higher when the index was bacteriologically positive (43.6% [95% CI, 16.5–70.8%] versus 23.8% [95% CI, 16.2–31.4%]). These results suggest that contact investigation and general surveillance in schools from high-burden settings merit consideration as means to improve early case detection in children.

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“…No data were available about transmission rates from sputum-negative children, but two recent reports from Paranjothy et al and Baghaie et al . showed an extensive transmission from two smear negative children aged 9 and 15 years, showing that transmission of M. tuberculosis from smear-negative children is possible [ 17 , 19 ]. However it is not clear if contacts involved in these reports have some other risk factors for TB, for example being household contacts of adults with TB [ 18 , 20 ].…”

Section: Differences In Transmissionmentioning

confidence: 99%

Clinical peculiarities of tuberculosis

et al. 2014

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The ongoing spread of tuberculosis (TB) in poor resource countries and the recently increasing incidence in high resource countries lead to the need of updated knowledge for clinicians, particularly for pediatricians. The purpose of this article is to provide an overview on the most important peculiarities of TB in children. Children are less contagious than adults, but the risk of progression to active disease is higher in infants and children as compared to the subsequent ages. Diagnosis of TB in children is more difficult than in adults, because few signs are associated with primary infection, interferon-gamma release assays and tuberculin skin test are less reliable in younger children, M. tuberculosis is more rarely detected in gastric aspirates than in smears in adults and radiological findings are often not specific. Treatment of latent TB is always necessary in young children, whereas it is recommended in older children, as well as in adults, only in particular conditions. Antimycobacterial drugs are generally better tolerated in children as compared to adults, but off-label use of second-line antimycobacterial drugs is increasing, because of spreading of multidrug resistant TB worldwide. Given that TB is a disease which often involves more than one member in a family, a closer collaboration is needed between pediatricians and clinicians who take care of adults.

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Contact tracing of a 15-year-old girl with smearnegative pulmonary tuberculosis in Tehran

Cited by 9 publications

References 12 publications

How to manage children who have come into contact with patients affected by tuberculosis

How to manage children who have come into contact with patients affected by tuberculosis

Mycobacterium tuberculosis Infection in School Contacts of Tuberculosis Cases: A Systematic Review and Meta-Analysis

Clinical peculiarities of tuberculosis

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