Enfants au contact d’individus atteints d’une tuberculose multi-résistante : quelles stratégies adopter ? Analyse de 46 enfants contacts et revue de la littérature

Catho, Gaud; Sénéchal, Agathe; Ronnaux-Baron, A.; Valour, Florent; Perpoint, Thomas; Bouaziz, A.; Dumitriescu, O.; Reix, Philippe; Pedone, Claudia; Ader, Florence

doi:10.1016/j.pneumo.2015.05.003

Cited by 5 publications

(1 citation statement)

References 24 publications

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“…The relatively low proportion of presumptive TB cases and overall yield of TB among children in our study is worrying. Even though, little is known globally about the actual disease burden among children, they likely represent a large pool of exposed, undiagnosed, and untreated active and latent infections [16]. We therefore suspect that the yield in our setting is likely underestimated.…”

Section: Discussionmentioning

confidence: 99%

Yield of facility-based verbal screening amongst household contacts of patients with multi-drug resistant tuberculosis in Pakistan

Qadeer¹,

Fatima²,

Haq³

et al. 2017

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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BackgroundHousehold contacts of multidrug-resistant tuberculosis (MDR-TB) patients are at a high risk of getting infected with TB/MDR-TB, therefore symptomatic or vulnerable individuals should be screened and treated early.MethodsA cross-sectional study was conducted among household contacts of MDR-TB patients in three high-burden TB sites in Pakistan from July 2013 to June 2014. MDR-TB index patients were asked to provide a list of all members of their household and were asked whether any of them had TB symptoms such as productive cough, fever, weight loss and night sweat (“facility-based verbal screening”). Symptomatic contacts were defined as presumptive TB cases and were invited for investigations at the facility. Those who did not come were paid a home-visit. Confirmed TB/MDR-TB patients were registered in the nearest treatment facility.ResultsOf 209 MDR-TB index patients, 1467 household contacts were identified and screened, 95 of them children < 5 years. Of these 172 (12%) were symptomatic. Most common symptoms were cough 157 (91%) and fever 107 (62%). 58 (34%) presumptive TB contacts were not investigated. Of total contacts, 56 (3.8%) were diagnosed with TB, among them 54(96%) with MDR-TB and 2(4%) with drug-susceptible-TB. The number needed to screen (NNS) to identify a new MDR-TB case among adult household contacts was 27 and among presumptive adult and pediatric TB contacts was three. All 56 confirmed patients were registered for treatment.ConclusionScreening household contacts of MDR-TB index cases may be considered a feasible and high yield option, in high-burden, low-resource settings within Pakistan. The number of presumptive TB contacts required to screen to identify a new MDR-TB case was unusually low, indicating an effective strategy that could easily be scaled-up. The screening and management of vulnerable adults and children living with patients having TB of any form is a major priority in the combined efforts to end TB.

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Section: Discussionmentioning

confidence: 99%

Yield of facility-based verbal screening amongst household contacts of patients with multi-drug resistant tuberculosis in Pakistan

Qadeer¹,

Fatima²,

Haq³

et al. 2017

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Limited benefit of CT scans in tuberculosis contact tracing

Yoshiyama

Kurosaki

Ogata

et al. 2019

Journal of Infection and Chemotherapy

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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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Enfants au contact d’individus atteints d’une tuberculose multi-résistante : quelles stratégies adopter ? Analyse de 46 enfants contacts et revue de la littérature

Cited by 5 publications

References 24 publications

Yield of facility-based verbal screening amongst household contacts of patients with multi-drug resistant tuberculosis in Pakistan

Yield of facility-based verbal screening amongst household contacts of patients with multi-drug resistant tuberculosis in Pakistan

Limited benefit of CT scans in tuberculosis contact tracing

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

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