Adriana Margarit1, Sílvia Simó1, Librada Rozas2, Àngela Deyà-Martínez1, Irene Barrabeig3, Amadéu Gené4, Clàudia Fortuny1, Antoni Noguera-Julian5. 1. Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España. 2. Unitat de Referència de Tuberculosi en el Nen, Direcció d'Infermeria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España. 3. Unitat de Vigilància Epidemiològica, Regió Barcelona Sud, Agència de Salut Pública de Catalunya, L'Hospitalet de Llobregat, Barcelona, España. 4. Servei de Microbiologia, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España. 5. Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España. Electronic address: ton@hsjdbcn.org.
Abstract
INTRODUCTION: Adolescents may present with adult-type pulmonary tuberculosis (TB), including cavity disease in upper lobes and smear-positive sputum, which involves a significant transmission risk for social and family contacts. PATIENTS AND METHODS: A retrospective (2007-2012) observational study of a case series of TB was conducted in children and adolescents (<18 years) in a paediatric referral centre in Barcelona. Patients aged≤12 and>12 years at diagnosis are compared. RESULTS: The series consisted of 124 patients (56.5% males, median age: 4.0 years). In half of the cases, the patient was of immigrant origina and TB was diagnosed after clinical-radiological suspicion, intra-thoracic disease being the most common (91.9%). Cultures yielded positive results in one third of cases (37.9%) and isolates were sensitive to oral first-line anti-TB agents in 100%. Median (interquartile range) duration of treatment was 6 (6-9) months, directly observed therapy was needed in 10 patients, and there was a satisfactory outcome after treatment in 98.4%. Among adolescents, TB was more prevalent in females (63.2%) and immigrant patients (68.4%), comorbidity at diagnosis and lung cavity forms were more common, and the source case was identified only in 21.1% of the patients. CONCLUSION: Adult-type pulmonary TB is common among adolescents, may be associated with underlying medical conditions, and is often diagnosed late, posing a significant transmission risk to the community.
INTRODUCTION: Adolescents may present with adult-type pulmonary tuberculosis (TB), including cavity disease in upper lobes and smear-positive sputum, which involves a significant transmission risk for social and family contacts. PATIENTS AND METHODS: A retrospective (2007-2012) observational study of a case series of TB was conducted in children and adolescents (<18 years) in a paediatric referral centre in Barcelona. Patients aged≤12 and>12 years at diagnosis are compared. RESULTS: The series consisted of 124 patients (56.5% males, median age: 4.0 years). In half of the cases, the patient was of immigrant origina and TB was diagnosed after clinical-radiological suspicion, intra-thoracic disease being the most common (91.9%). Cultures yielded positive results in one third of cases (37.9%) and isolates were sensitive to oral first-line anti-TB agents in 100%. Median (interquartile range) duration of treatment was 6 (6-9) months, directly observed therapy was needed in 10 patients, and there was a satisfactory outcome after treatment in 98.4%. Among adolescents, TB was more prevalent in females (63.2%) and immigrant patients (68.4%), comorbidity at diagnosis and lung cavity forms were more common, and the source case was identified only in 21.1% of the patients. CONCLUSION: Adult-type pulmonary TB is common among adolescents, may be associated with underlying medical conditions, and is often diagnosed late, posing a significant transmission risk to the community.
Authors: Kaitlyn M Berry; Carly A Rodriguez; Rebecca H Berhanu; Nazir Ismail; Lindiwe Mvusi; Lawrence Long; Denise Evans Journal: BMC Public Health Date: 2019-07-22 Impact factor: 3.295