Transmission of tuberculosis from a seven‐year‐old child in a Sydney school

Cardona, Magnolia; Bek,; Mills, Kay; Isaacs, David; Alperstein, Garth

doi:10.1046/j.1440-1754.1999.00385.x

Cited by 26 publications

(12 citation statements)

References 16 publications

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“…It is rare for children < 10 years of age to develop the adult type of tuberculosis, but those children of any age with extensive infiltrates, sputum production, or cavity on chest x-ray should be isolated when in health care facilities until it can be determined that they are not infectious. 10,11 Because most children who develop tuberculosis disease do so within a few months of acquiring the infection, one should be sure that the adults accompanying the child are not the source of the child's infection by performing chest radiographs on them. 4,12 It is commonly asked why young children with the childhood type of tuberculosis are not infectious.…”

Section: Natural History and Pathophysiologymentioning

confidence: 99%

Tuberculosis in Children

Starke

2004

Seminars in Respiratory and Critical Care Medicine

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The natural history and clinical expression of infection due to Mycobacterium tuberculosis differ substantially in children compared with adults. The natural history depends upon the age at infection and the host immune status. Children infected prior to age 4 have a very high rate of developing immediate clinical or radiographic manifestations or both, but are unlikely to develop reactivation disease in adulthood. In contrast, children infected in preadolescence or adolescence are more prone to developing more severe adult-type pulmonary tuberculosis soon after infection or in adulthood. It is difficult to confirm the diagnosis of tuberculosis by current microbiological methods. Even in industrialized countries, the triad of a positive tuberculin skin test, radiographic and/or clinical manifestations consistent with tuberculosis, and establishing a recent link to a known infectious case of tuberculosis is the "gold standard" for diagnosis. Children with tuberculosis respond well to and tolerate the same basic treatment regimens as used for adults. Some prevention of childhood tuberculosis can be achieved by the use of the bacille Calmette-Guérin (BCG) vaccines, but the use of chemotherapy to treat recent tuberculosis infection, discovered via contact tracing, is of paramount importance even when BCG vaccines are used.

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Section: Natural History and Pathophysiologymentioning

confidence: 99%

Tuberculosis in Children

Starke

2004

Seminars in Respiratory and Critical Care Medicine

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“…Of the estimated 9.3 million annual incident TB cases in the world in the year 2007, at-least 1 million are estimated to be less than 15 years of age [3]. Children are susceptible to infection with M. tuberculosis in the community, at greater risk of progressing to active disease when infected at a very young age [4] and there are also well-documented cases of children acting as a source of infection within a community [5], [6], [7]. These considerations justify a focus on the proper management of childhood TB for the control of TB.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Programme-Defined Treatment Outcomes among Childhood Tuberculosis (TB) Patients under the National TB Programme in Delhi

et al. 2010

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BackgroundChildhood tuberculosis (TB) patients under India's Revised National TB Control Programme (RNTCP) are managed using diagnostic algorithms and directly observed treatment with intermittent thrice-weekly short-course treatment regimens for 6–8 months. The assignment into pre-treatment weight bands leads to drug doses (milligram per kilogram) that are lower than current World Health Organization (WHO) guidelines for some patients.ObjectivesThe main aim of our study was to describe the baseline characteristics and treatment outcomes reported under RNTCP for registered childhood (age <15 years) TB patients in Delhi. Additionally, we compared the reported programmatic treatment completion rates between children treated as per WHO recommended anti-TB drug doses with those children treated with anti-TB drug doses below that recommended in WHO guidelines.MethodsFor this cross-sectional retrospective study, we reviewed programme records of all 1089 TB patients aged <15 years registered for TB treatment from January to June, 2008 in 6 randomly selected districts of Delhi. WHO disease classification and treatment outcome definitions are used by RNTCP, and these were extracted as reported in programme records.Results and ConclusionsAmong 1074 patients with records available, 651 (61%) were females, 122 (11%) were <5 years of age, 1000 (93%) were new cases, and 680 (63%) had extra-pulmonary TB (EP-TB)—most commonly peripheral lymph node disease [310 (46%)]. Among 394 pulmonary TB (PTB) cases, 165 (42%) were sputum smear-positive. The overall reported treatment completion rate was 95%. Similar reported treatment completion rates were found in all subgroups assessed, including those patients whose drug dosages were lower than that currently recommended by WHO. Further studies are needed to assess the reasons for the low proportion of under-5 years of age TB case notifications, address challenges in reaching all childhood TB patients by RNTCP, the accuracy of diagnosis, and the clinical validity of reported programme defined treatment completion.

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“…Schools, close person-to-person contact and age-specific susceptibility factors present elevated risk for the emergence of tuberculosis microepidemics (Cardona, Bek, Mills, Isaacs, & Alperstein, 1999;Washko, Robinson, Fehrs, & Frieden, 1998). According to statistics from Taiwan's Department of Health, Executive Yuan, ROC (2002), the incidence rate for TB among subjects aged 15 to 25 (school age) increased from 2.33 per 100,000 people in 1996 to 2.51 in 1999.…”

Section: Introductionmentioning

confidence: 99%

Applying the Health Belief Model to Analyze Intention to Participate in Preventive Pulmonary Tuberculosis Chest X-Ray Examinations Among Indigenous Nursing Students

Chang

Hung

Chou

et al. 2007

Journal of Nursing Research

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The purpose of this study was to investigate knowledge, perceptions of tuberculosis (TB) and intent to receive chest X-ray screening among indigenous (Taiwanese of ethnic Malayo-Polynesian descent) nursing students in Taiwan. A convenience sample was chosen from an technical institute in northern Taiwan that maintained admission quotas and provided scholarships for indigenous students. This school had over 150 classes and around 7,000 students, about 20%-25% of whom were ethnically indigenous. A power analysis based on a pilot study showed that a large effect size required a minimum sample of 485. To attain this number, 50 classes from years one through five were randomly selected based on an expected sampling of 20 students per classroom. In all, 1,000 questionnaires were distributed and 865 returned, for a response rate of 86.5%. A cross-sectional study design was used, and this study was run between the months of February and June 2003. Survey responses were self-reported in two questionnaires that gathered information on respondent knowledge and perceptions regarding TB and intent to take chest X-ray tests. Study results showed a moderate level of general knowledge about TB, misunderstandings regarding transmission vectors, and low perceptions regarding susceptibility. The knowledge score was associated with perceived benefits and barriers to preventing TB. Different places of residence influenced perceived barriers to preventing and treating TB. Age was negatively associated with the perceived benefits of receiving a chest X-ray exam for TB. Indigenous nursing students with higher perceptions of susceptibility and severity and lower perception of barriers on preventing TB had a higher level of intent to take the X-ray exam. Nursing schools must address the subject of TB in-depth and design age-specific curricula that incorporate multifaceted strategies for different students. Additionally, health educators should design health education programs targeted to dispel misconceptions and improve both knowledge and levels of awareness of tuberculosis among the indigenous population in order to enhance their willingness and ability to detect TB.

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Transmission of tuberculosis from a seven‐year‐old child in a Sydney school

Cited by 26 publications

References 16 publications

Tuberculosis in Children

Tuberculosis in Children

Characteristics and Programme-Defined Treatment Outcomes among Childhood Tuberculosis (TB) Patients under the National TB Programme in Delhi

Applying the Health Belief Model to Analyze Intention to Participate in Preventive Pulmonary Tuberculosis Chest X-Ray Examinations Among Indigenous Nursing Students

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