Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis

Abstract

Aims: To study the prevalence of tuberculosis infection among children in household contact with adults having pulmonary tuberculosis, and identify the possible risk factors. Methods: Children under the age of 5 years who were in household contact with 200 consecutive adults with pulmonary tuberculosis underwent tuberculin skin testing. Transverse induration of greater than 10 mm was defined as positive tuberculin test suggestive of tubercular infection. Infected children underwent chest radiography and analysis of gastric lavage fluid or induced sputum for detection of acid fast bacilli. Results: Tuberculin test was positive in 95 of 281 contacts (33.8%), of which 65 were contacts of sputum positive patients, while 30 were contacts of sputum negative patients. Nine of these children were diagnosed as having tuberculosis based on clinical features and/or recovery of acid fast bacilli; seven were in contact with sputum positive adults. The important risk factors for transmission of infection were younger age, severe malnutrition, absence of BCG vaccination, contact with an adult who was sputum positive, and exposure to environmental tobacco smoke. Conclusion: The prevalence of tuberculosis infection and clinical disease among children in household contact with adult patients is higher than in the general population, and risk is significantly increased by contact with sputum positive adults.

What cannot be measured cannot be done; risk factors for childhood tuberculosis: a case control study

“…The present study showed that, children of the wage laborer had the higher proportion of infection which corresponds to a study where children of service holders had significant reduced risk (p=0.039) to develop TB than others 10 . Increased size of household was found to be important in previous studies and overcrowding has been documented as a risk factor for TB from several other studies in a variety of settings [9][10]15 .…”

“…Child tuberculosis was found to be associated with educational attainment and also working status of mother in bivariate analyses but found not significant in multivariate analysis. Children of working mothers' had more chance to develop tuberculosis which contradicts previous studies 10 . Literate parents involved them in various jobs resulting less attention to their children.…”

“…crowding, economic status, and education were significantly associated with the TB case notification rate in children 0-5 years old [7][8] . Other factors like, the absence of a ceiling, walls made of mud, household crowding, and a history of TB in another member of the household were found to be associated with TB disease [9][10] .…”

Tobacco and tuberculosis

“…This increase has been observed in adult smokers, as well as in non-smoking adults and children passively exposed to tobacco smoke. The risk for children passively exposed to tobacco smoke and tuberculosis was assessed in several studies in US [9], India [10], South Africa [11] and Spain [12]. The relative risk was proportional to the intensity and duration of exposure and is evaluated between 1.7 and 3.2.…”

The importance of chemoprophylaxis in tuberculosis: On occasion of eight cases in the same family

“…Temaslının immunsupresif, beş yaşından küçük veya 60 yaşından büyük olması hastalık riskini oldukça arttırmaktadır [11]. Ancak 15 yaş altı temaslı-lar önemli bir risk grubunu oluşturmaktadır.…”