Roxana Mansour Ghanaie1, Abdollah Karimi1, Leila Azimi1, Seddon James2, Mahshid Nasehi3,4, Abolfazl Panahi Mishkar5, Mahnaz Sheikhi6, Fatemeh Fallah1, Sedigheh Rafiei Tabatabaei1, Seyedeh Mahsan Hoseini-Alfatemi7. 1. Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Centre for International Child Health, Department of Paediatrics, Imperial College London, London, UK. 3. Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran. 4. Department of Epidemiology and Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. 5. Deputy of Health, Zabol University of Medical Science, Zabol, Iran. 6. TB Coordinator of Deputy Health, Golestan University of Medical Sciences, Gorgan, Golestan, Iran. 7. Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran. mahsan.hoseinialfatemi@gmail.com.
Abstract
BACKGROUND: Although the World Health Organization has recommended the diagnosis and prophylactic treatment of latent tuberculous infection (LTBI) in child household contacts of tuberculosis (TB) cases, the national programs in high-burden TB regions rarely implement adequate screening of this high-risk group, mainly because of resource limitations. We aimed to evaluate the prevalence of LTBI among pediatric household contacts of TB cases in two high-burden provinces in Iran. METHODS: We conducted a cohort study in children who had been in household contact with a TB index. All subjects were assessed for active TB disease. For LTBI diagnosis, tuberculin skin test (TST) and QuantiFERON®-TB Gold Plus (QFT-Plus) were performed at the time of the index TB case diagnosis, as well as, 3, 12, and 18 months, if the first results were negative. In addition, interferon-γ-induced protein-10(IP-10) concentrations were measured for all participants. RESULTS: A total of 230 children were enrolled, who had contact with an index TB case. Three contacts were diagnosed with active TB. According to the TST/QFT-Plus results, 104 (45.2%) children were identified with LTBI during our study. Significantly increased IP-10 levels were found in LTBI patients compared to healthy contacts. Accordingly, more than 50% of LTBI contacts and about 10% of healthy contacts were considered as IP-10-positive. CONCLUSION: This study alarmingly illustrates a high prevalence of LTBI among Iranian children exposed to TB cases. We, therefore, emphasize that the children living in close contact with an infectious TB case should be screened effectively and receive prophylactic therapy.
BACKGROUND: Although the World Health Organization has recommended the diagnosis and prophylactic treatment of latent tuberculous infection (LTBI) in child household contacts of tuberculosis (TB) cases, the national programs in high-burden TB regions rarely implement adequate screening of this high-risk group, mainly because of resource limitations. We aimed to evaluate the prevalence of LTBI among pediatric household contacts of TB cases in two high-burden provinces in Iran. METHODS: We conducted a cohort study in children who had been in household contact with a TB index. All subjects were assessed for active TB disease. For LTBI diagnosis, tuberculin skin test (TST) and QuantiFERON®-TB Gold Plus (QFT-Plus) were performed at the time of the index TB case diagnosis, as well as, 3, 12, and 18 months, if the first results were negative. In addition, interferon-γ-induced protein-10(IP-10) concentrations were measured for all participants. RESULTS: A total of 230 children were enrolled, who had contact with an index TB case. Three contacts were diagnosed with active TB. According to the TST/QFT-Plus results, 104 (45.2%) children were identified with LTBI during our study. Significantly increased IP-10 levels were found in LTBI patients compared to healthy contacts. Accordingly, more than 50% of LTBI contacts and about 10% of healthy contacts were considered as IP-10-positive. CONCLUSION: This study alarmingly illustrates a high prevalence of LTBI among Iranian children exposed to TB cases. We, therefore, emphasize that the children living in close contact with an infectious TB case should be screened effectively and receive prophylactic therapy.
Authors: L Petrone; A Cannas; V Vanini; G Cuzzi; F Aloi; M Nsubuga; J Sserunkuma; R A Nazziwa; L Jugheli; T Lukindo; E Girardi; A Antinori; L Pucci; K Reither; D Goletti Journal: Int J Tuberc Lung Dis Date: 2016-11 Impact factor: 2.373
Authors: B J Marais; R P Gie; H S Schaaf; A C Hesseling; C C Obihara; J J Starke; D A Enarson; P R Donald; N Beyers Journal: Int J Tuberc Lung Dis Date: 2004-04 Impact factor: 2.373
Authors: Knut Lönnroth; Giovanni Battista Migliori; Ibrahim Abubakar; Lia D'Ambrosio; Gerard de Vries; Roland Diel; Paul Douglas; Dennis Falzon; Marc-Andre Gaudreau; Delia Goletti; Edilberto R González Ochoa; Philip LoBue; Alberto Matteelli; Howard Njoo; Ivan Solovic; Alistair Story; Tamara Tayeb; Marieke J van der Werf; Diana Weil; Jean-Pierre Zellweger; Mohamed Abdel Aziz; Mohamed R M Al Lawati; Stefano Aliberti; Wouter Arrazola de Oñate; Draurio Barreira; Vineet Bhatia; Francesco Blasi; Amy Bloom; Judith Bruchfeld; Francesco Castelli; Rosella Centis; Daniel Chemtob; Daniela M Cirillo; Alberto Colorado; Andrei Dadu; Ulf R Dahle; Laura De Paoli; Hannah M Dias; Raquel Duarte; Lanfranco Fattorini; Mina Gaga; Haileyesus Getahun; Philippe Glaziou; Lasha Goguadze; Mirtha Del Granado; Walter Haas; Asko Järvinen; Geun-Yong Kwon; Davide Mosca; Payam Nahid; Nobuyuki Nishikiori; Isabel Noguer; Joan O'Donnell; Analita Pace-Asciak; Maria G Pompa; Gilda G Popescu; Carlos Robalo Cordeiro; Karin Rønning; Morten Ruhwald; Jean-Paul Sculier; Aleksandar Simunović; Alison Smith-Palmer; Giovanni Sotgiu; Giorgia Sulis; Carlos A Torres-Duque; Kazunori Umeki; Mukund Uplekar; Catharina van Weezenbeek; Tuula Vasankari; Robert J Vitillo; Constantia Voniatis; Maryse Wanlin; Mario C Raviglione Journal: Eur Respir J Date: 2015-04 Impact factor: 16.671