Update on the diagnosis and treatment of tuberculosis

Baquero‐Artigao, Fernando; Rosal, Teresa Del; Falcón-Neyra, Lola; Ferreras-Antolín, Laura; Gómez‐Pastrana, David; Hernanz-Lobo, Alicia; Méndez-Echevarría, Ana; Noguera-Julián, Antoni; Sánchez, María Teresa Pascual; Rodríguez-Molino, Paula; Pérez, Roi Piñeiro; Santiago-García, Begoña; Soriano-Arandes, Antoni

doi:10.1016/j.anpede.2023.03.009

Cited by 4 publications

(4 citation statements)

References 45 publications

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“…In treating TB, the discovery of novel second line anti TB drugs, including those intended for pediatric use and the validation of short treatment courses for certain patients based on clinical trials are all new developments. [ 29 ] In our study the most vulnerable population was the age of 60 to 64 followed by the age of 70 to 74 and then 50 to 54 years.…”

Section: Discussionmentioning

confidence: 64%

Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study

Khursheed,

Wazir,

Saleem

et al. 2024

Medicine

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Tuberculosis (TB) remains a serious problem for public health and a leading cause of death after COVID-19 and superior to even HIV/AIDS. It is a social health issue and can cause stigma and economic loss as the person cannot perform professionally due to lethargy caused by disease. It is a retrospective study done on data from National TB program Muzaffarabad chapter. The details were noted on SPSS and analysis was done to find important demographic characteristics. The total number of patients was 3441; among which 48.76% were males. Most of them (81.11%) belonged to the Muzaffarabad division of Azad Jammu and Kahmir (AJK). The microbiologically or culture positive cases were 440. Rifampicin resistance was present in 147 cases, further categorized as high (n = 143), very high (n = 3), or true positive (n = 1) resistance. Muti drug resistance was found in 19 cases. The microscopy culture is more sensitive (AUC = 0.511) than MTB/RIF or serology (AUC = 0.502) according to ROC. The rate of positive smear results is not very satisfactory in the present study as it cannot detect dormant or latent cases. There is a need to establish more sensitive tests for detection of cases and more research to combat the disease.

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Section: Discussionmentioning

confidence: 64%

Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study

Khursheed,

Wazir,

Saleem

et al. 2024

Medicine

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“… 17 LTBI was defined as conversion to a positive TST (≥ 5 mm) and/or a QFT-Plus positive result in the absence of clinical signs or symptoms or radiological findings consistent with active TB in accordance with Spanish Guidelines. 16 The Bacillus Calmette-Guérin (BCG) vaccine has not been included in the Catalan vaccination schedule since 1974.…”

Section: Discussionmentioning

confidence: 99%

“…Children with a baseline TST result ≥5 mm were excluded from the study and managed as per local guidelines. 16 A follow-up visit was conducted 8 to 12 weeks after their return from the VFR trip. During this visit, further epidemiological and clinical data were collected and both a TST and a QuantiFERON- TB Gold Plus test (QFT-Plus; Cellestis/Qiagen, Hilden, Germany) were performed the same day or, alternatively, within a maximum interval of 7 days.…”

Section: Methods and Designmentioning

confidence: 99%

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Tuberculosis among children visiting friends & relatives

Perez-Porcuna,

Noguera-Julian,

Riera-Bosch

et al. 2024

Journal of Travel Medicine

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Background Most paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR. Methods We conducted a prospective multicentric observational study in Catalonia (Spain) from 06/2017 to 12/2019. We enrolled children aged < 15 years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent’s birth country for ≥21 days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8–12 weeks post-return. LTBI was defined as a TST ≥5 mm and/or a positive QFT-Plus. Results Five hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU,95%CI = 8.8–28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3–9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU,95%CI = 3.9–20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1–13.3). Conclusions The risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.

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Position statement on infection screening, prophylaxis, and vaccination in pediatric patients with rheumatic diseases and immunosuppressive therapies, part 2: infection prophylaxis

et al. 2023

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This study aims to provide practical recommendations on prophylaxis for infection in pediatric patients with immune-mediated rheumatic diseases receiving/scheduled to receive immunosuppressive therapy. A qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using MeSH terms and free text to identify articles that analyzed data on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapy. The results were presented and discussed in a nominal group meeting comprising a committee of 12 pediatric rheumatologists from the Prevention and Treatment of Infections Working Group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process that was extended to members of the Spanish Society of Pediatric Rheumatology and the Vaccine Advisory Committee of the Spanish Association of Pediatrics. Participants produced a score ranging from 0 (completely disagree) to 10 (completely agree). Agreement was considered to have been reached if at least 70% of participants voted ≥ 7. The literature review included more than 400 articles. Overall, 63 recommendations were generated (23 on infection prophylaxis) and voted by 59 pediatric rheumatologists and other pediatric specialists, all of whom achieved the pre-established level of agreement. The recommendations on prophylaxis of infection cover vaccination and prophylaxis against varicella zoster virus, tuberculosis, Pneumocystis jiroveccii, and invasive fungal infections in pediatric patients with immune-mediated rheumatic diseases receiving/scheduled to receive immunosuppressive therapy. Conclusion: Based on current evidence and a Delphi process, we provided consensus and updated recommendations on prophylaxis and treatment of infections to guide those caring for pediatric rheumatology patients. What is Known: •Data largely derived from adults find that infectious diseases and related complications are a major cause of morbidity and mortality in patients with immune-mediated rheumatic diseases. •It is crucial to be aware of the preventive measures that should be implemented to prevent these infections in children, although most guidelines are often extrapolated from adult cases. What is New: •In the absence of evidence, a literature review and a Delphi survey were conducted to establish a series of expert recommendations that could prove useful in clinical practice, providing a practical and simple day-to-day approach to be used by pediatric rheumatologists. •The recommendations focus on tuberculosis, herpes zoster virus, fungal infections, and Pneumocystis jirovecii.

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Update on the diagnosis and treatment of tuberculosis

Cited by 4 publications

References 45 publications

Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study

Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study

Tuberculosis among children visiting friends & relatives

Position statement on infection screening, prophylaxis, and vaccination in pediatric patients with rheumatic diseases and immunosuppressive therapies, part 2: infection prophylaxis

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