Tuberculosis infection in children who are contacts of immigrant tuberculosis patients

Abstract

The present study aimed to determine what proportion of children who are in close contact with immigrant tuberculosis (TB) patients are infected with Mycobacterium tuberculosis.For 1.5 yrs, 14 municipal health services in the Netherlands collected data from all non-Dutch TB patients and their contacts. Close contacts aged ,16 yrs received a tuberculin skin test (TST). A positive TST was defined as an induration of o10 mm among nonvaccinated children, and o16 mm among bacille Calmette-Guérin-vaccinated children.In total, 244 patients had 359 close contacts aged ,16 yrs. Nine out of the 359 (2.5%) had TB. A TST test was given to 298 out of the 359 (83%). Of the 115 contacts of 44 extrapulmonary TB patients, three (3%) had a positive TST. Of the 186 contacts of 58 positive pulmonary TB patients, 30 (16%) had a positive TST. Contacts of sputum smear-positive patients significantly more often had a positive TST (25%), compared with the contacts of sputum smear-negative patients (7%). Children born abroad significantly more often had a positive TST (20%) than children born in the Netherlands (5%).In conclusion, the prevalence of active tuberculosis and latent tuberculosis infection among children who are close contacts of immigrant tuberculosis patients is high and warrants an expansion of contact investigation.

Community-based Targeted Case Finding for Tuberculosis and HIV in Household Contacts of Patients with Tuberculosis in South Africa

“…Previous studies have found that contacts of smearpositive index cases are more likely to be infected with TB and develop TB (15,16). Our study found no difference in the odds of TB disease between contacts of smear-negative and smearpositive index patients.…”

Proposed management of childhood tuberculosis in low-incidence countries

“…Children who have spent a longer time (i.e. >1 month) in a high-prevalence country in close contact with the local population should be tested immediately after their return and retested after 3 months if the initial result is negative (Table 1) [44,82]. Disease has to be excluded in every child with signs of infection (e.g.…”

“…in Germany, towards targeted testing for tuberculosis infection and suspension of BCG vaccination [19]. Nevertheless, tuberculosis is still regarded as a serious infection, particularly with the background of migration and emerging drug resistance [28,82]. The goal of preventive measures therefore remains the early diagnosis and treatment of primary tuberculosis infections.…”

Vigilancia y análisis de zonas de frontera, puertos de entrada y de población inmigrante1

“…Se recolectaron datos de todos los pacientes inmigrantes con tuberculosis y sus contactos; fueron incluidos los pacientes nacidos en los Países Bajos con padres no holandeses y también los solicitantes de asilo y otros inmigrantes. Como método de evaluación de los factores de riesgo para la infección, los niños con una prueba de sensibilidad a la tuberculina positiva y sus pacientes índices se compararon con aquellos con una tuberculina negativa, por medio de un análisis de regresión logística (21).…”