The incidence of tuberculosis among adolescents and young adults: a global estimate

Snow, Kathryn; Sismanidis, Charalambos; Denholm, Justin T.; Sawyer, Susan Μ; Graham, Stephen M.

doi:10.1183/13993003.02352-2017

Cited by 125 publications

(116 citation statements)

References 13 publications

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“…1 An estimated 1.8 million adolescents and young adults around the world develop tuberculosis disease each year, a burden which has been elucidated only recently due to a historical focus within tuberculosis surveillance on "children" (aged 0-14 years) and "adults" (aged ≥15 years), neglecting adolescents entirely. 5 In high-burden settings, adolescents make up both a substantial proportion of the general population, and a substantial proportion of patients with tuberculosis. 5 This creates a major need for high-quality tuberculosis services which are accessible and acceptable to adolescents, both to facilitate timely diagnosis and to support medication adherence and treatment completion.…”

Section: Introductionmentioning

confidence: 99%

“…5 In high-burden settings, adolescents make up both a substantial proportion of the general population, and a substantial proportion of patients with tuberculosis. 5 This creates a major need for high-quality tuberculosis services which are accessible and acceptable to adolescents, both to facilitate timely diagnosis and to support medication adherence and treatment completion. Despite the growing recognition of adolescence as a period of escalating risk and increasing burden of tuberculosis, to date, adolescents have not been addressed as a distinct population within tuberculosis control efforts.…”

Section: Introductionmentioning

confidence: 99%

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Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

119

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Adolescence is characterised by a dramatic increase in the incidence of tuberculosis, a fact that has been appreciated since the early 20 th century. The majority of the world's adolescents live in low and middle-income countries where tuberculosis remains common, and where they comprise one quarter of the population. Despite this, adolescents have not yet been addressed as a distinct population in tuberculosis policy or within tuberculosis treatment services, and emerging evidence suggests that current models of care do not meet their needs.This article reviews current knowledge about tuberculosis in adolescence with a focus on the management of infection and disease, including HIV co-infection and rifampicin-resistant tuberculosis. Recent progress in vaccine development is outlined and important directions for future research are highlighted. Search strategy and selection criteriaThis was a narrative review of the literature on adolescent tuberculosis, informed by expert opinion and clinical experience. We reviewed the English-and Spanish-language literature for studies on adolescent tuberculosis to identify case series documenting clinical presentation and treatment outcomes. We searched PubMed with the following string on 19August 2019: ('tuberculosis'[Title]) AND ('adolescent'[TIAB]). The search returned 210 results, of which 11 were eligible for inclusion (Table 1), and we identified three additional studies from reference lists, for a total of 14 studies. Studies reporting solely on prevalence or where data from adolescents was aggregated with those of younger children or adults were excluded. Data were extracted regarding major site(s) of disease, percent of adolescents with microbiologic confirmation, adverse drug reactions, and final treatment outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

119

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“…Tuberculosis case detection is likely low for this group compared to others [2, 3]. A recent report estimated that the global tuberculosis burden among adolescents was 1.78 million, accounting for almost 20% of global tuberculosis cases [4]. The tuberculosis literature is devoid of information on the risk of tuberculosis infection and disease progression among individuals in adolescence and this has impeded targeted control efforts [5].…”

Section: Introductionmentioning

confidence: 99%

A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

You

Zhu

et al. 2019

Epidemiol. Infect.

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Adolescents have been largely neglected from tuberculosis control efforts. In low- to medium burden settings much of the tuberculosis burden in this age group occurs from school outbreaks. We report on a large tuberculosis outbreak in adolescents from a boarding high school in Jiangsu Province, China. From March to June 2018, a tuberculosis outbreak occurred in a boarding high school. We conducted an outbreak investigation involving clinical diagnostic tests and molecular analysis to determine the outbreak origin. Cases were detected through symptom screening, tuberculin skin testing (TST), chest radiography, sputum smear, solid sputum culture and GeneXpert MTB/RIF. Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping and spoligotyping methods were performed on Mycobacterium tuberculosis (M. tuberculosis) isolates to identify the outbreak origin. A total of 845 students and 131 teachers/staff attended a TST screening for tuberculosis infection. The prevalence of elevated tuberculin reactions at ≥5, ≥10 and ≥15 mm was 12.19% (119/976), 6.35% (62/976) and 3.28% (32/976), respectively. Radiographic abnormalities were present in 5.73% (56 of 976) individuals, 40 students and 16 teachers/staff. Of these, 12 students were diagnosed with confirmed tuberculosis. In total, 14 students (two index cases and 12 confirmed cases) were diagnosed and reported in the tuberculosis outbreak, an attack rate of 1.7% (14/847) among students (two index cases and 845 screened students). Results from MIRU-VNTR typing and spoligotyping analyses demonstrated that three M. tuberculosis strains belong to the Beijing family with corresponding MIRU-VNTR alleles. This school-based tuberculosis outbreak among adolescents demonstrates that transmission among individuals in this age group is common and must be prioritised. It suggests that identifying and timely diagnosis of smear-positive cases, especially in the early phase of outbreaks, is the key to preventing further spread among close contacts.

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“…We believe that assumptions used by SNOW et al [27] and the use of data from several countries with different epidemiological profiles have contributed to overcome the lack of age-disaggregated data. However, the variability of TB case detection across countries entails high complexity and potential sources of error.…”

mentioning

confidence: 99%

“…In this issue of the European Respiratory Journal, SNOW et al [27] estimated a global number of incident TB cases among adolescents and young adults (10-24 years) of 1.78 million in 2012, representing 17% of all new cases. Importantly, they show an upward trend in the TB caseload from 10 to 24 years of age, which could partially be attributed, as the authors acknowledge, to increasing rates of HIV.…”

mentioning

confidence: 99%