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Tb in children

Eugene Vortia, Victor E Uko, Belinda Yen-Lieberman, Jill Frawley, Sarah E Worley, Lara Danziger-Isakov, Barbara Kaplan, Lori Mahajan
Background: Tumor necrosis factor alpha (TNF-α) inhibitors are linked with increased risk of reactivation of active tuberculosis. The QuantiFERON-TB Gold In-Tube test is approved for screening latent tuberculosis infection in children and adults. There are limited data on the test performance in children on long-term treatment with TNF-α inhibitors. The objective of this study was to assess the proportion of indeterminate results for the QuantiFERON-TB Gold In-Tube in children with inflammatory bowel disease (IBD) on long-term infliximab treatment and to evaluate the range of interferon-γ responses to mitogen...
March 19, 2018: Inflammatory Bowel Diseases
Anthony J Garcia-Prats, Penelope C Rose, Heather R Draper, James A Seddon, Jennifer Norman, Helen M McIlleron, Anneke C Hesseling, H Simon Schaaf
BACKGROUND: Currently recommended treatment for multidrug-resistant (MDR) tuberculosis (TB) includes 4-8 months of an injectable medication, which is poorly tolerated. We evaluated the impact of co-administering lidocaine on pain and pharmacokinetics of intramuscular injections of amikacin in children with MDR-TB. METHODS: Children 8-18 years of age, receiving amikacin for MDR-TB treatment in Cape Town, South Africa, were eligible for this randomized crossover trial...
March 14, 2018: Pediatric Infectious Disease Journal
Basant Kumar, Vijai Dutta Upadhyaya, Sandeep Kumar Rahul, Laxmi Kant Bharti, Ram Nawal Rao, Sheo Kumar
Background: To analyse our experience with acute presentations of abdominal tuberculosis (TB) in children for early diagnosis and management. Materials and Methods: From December 2010 to April 2016, available electronic and operation theatre (OT) records of 17 patients with confirmed diagnosis of abdominal TB were analysed retrospectively. Parameters reviewed were age, sex, presentations, diagnostic investigations, surgery/intervention performed, final outcome and follow-up...
July 2017: African Journal of Paediatric Surgery: AJPS
Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Sanata Bamba, Adama Zida, Ibrahim Sangaré, Mamoudou Cissé, David W Denning, Christophe Hennequin
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the national demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0...
March 11, 2018: Journal of Fungi (Basel, Switzerland)
Lisa Frigati, Moherdran Archary, Helena Rabie, Martina Penazzato, Nathan Ford
Early mortality and morbidity remain high in children initiating antiretroviral therapy (ART), especially in sub-Saharan Africa. Many children still present with advanced human immunodeficiency virus (HIV) disease. Tuberculosis, pneumonia, and severe bacterial infections are the main causes of hospital admission in HIV-infected children. In contrast to adults with advanced HIV disease, cryptococcal disease is not common in childhood, although there is a peak in infancy and adolescence. Interventions such as TB screening in symptomatic children, and isoniazid and cotrimoxazole prophylaxis should be implemented...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Chidubem L Ogbudebe, Victor Adepoju, Christy Ekerete-Udofia, Ebere Abu, Ginika Egesemba, Nkem Chukwueme, Mustapha Gidado
Objectives: Understanding the factors that influence tuberculosis (TB) treatment outcomes in children is key to designing interventions to address them. This study aimed to determine the case category distribution of childhood TB in Nigeria and assess which clinical and demographic factors are associated with different treatment outcomes in childhood TB. Materials and methods: This was a retrospective cohort study involving a review of medical records of children (0-14 years) with TB in 3 states in Nigeria in 2015...
2018: Health Services Insights
Neeraj Raizada, Sunil D Khaparde, Soumya Swaminathan, Sanjay Sarin, Virender Singh Salhotra, Aakshi Kalra, Ashwani Khanna, K K Chopra, M Hanif, K R Umadevi, Syed Hissar, Sreenivas Achuthan Nair, C H Surya Prakash, B K Saha, Raghuram Rao, Claudia Denkinger, Catharina Boehme
BACKGROUND: Unlike in adults, diagnosis of TB can be challenging in children, as signs and symptoms of paediatric TB can be very non-specific and similar to other common childhood chest infections, which may lead to under or delayed diagnosis of TB disease. In spite of the increasing availability of rapid high-sensitivity diagnostics in public and private sectors, majority of paediatric TB cases are empirically diagnosed, without laboratory confirmation. To address these diagnostic challenges, World Health Organization (WHO) has recommended upfront Xpert MTB/RIF (Xpert) testing for the diagnosis of TB in paediatric presumptive pulmonary and extra-pulmonary TB (EPTB) cases...
2018: PloS One
Gladys Kigozi, Michelle Engelbrecht, Christo Heunis, André Janse van Rensburg
BACKGROUND: In 2012, the World Health Organization launched guidelines for systematically investigating contacts of persons with infectious tuberculosis (TB) in low- and middle-income countries. As such, it is necessary to understand factors that would influence successful scale-up. This study targeted household contacts of newly-diagnosed infectious TB patients in the Mangaung Metropolitan district to explore factors associated with non-attendance of clinical evaluation. METHOD: In September-October 2016, a pilot study of household contacts was conducted...
March 5, 2018: BMC Infectious Diseases
I Carvalho, D Goletti, S Manga, D R Silva, D Manissero, G Migliori
Tuberculosis (TB) is a major cause of childhood morbidity and mortality worldwide. The aim of this review is to describe the management of the child with TB and latent tuberculosis infection (LTBI). To develop this article, a working group reviewed relevant epidemiological and other scientific studies and established practices in conducting LBTI and TB in children. The article describes how to manage the child with LTBI, considering transmission and infectiousness of tuberculosis, contact screening and prioritization of contacts and recommendations on treatment of children with LTBI and how to manage the child with TB considering the susceptibility of children to developing tuberculosis, epidemiology and classification of tuberculosis in children, diagnosis and treatment...
March 1, 2018: Revista Portuguesa de Pneumologia
Fabian Speth, Claas H Hinze, Susanne Andel, Thomas Mertens, Johannes-Peter Haas
BACKGROUND: The goal of this study was to apply the varicella zoster virus (VZV) vaccine to patients with pediatric rheumatic diseases (PRD) at risk for severe chickenpox, without interrupting their current immunosuppression, including biological agents, using an immunological-based pre-vaccination checklist to assure safety. A pre-vaccination checklist was implemented to ensure adequate immune competence prior to immunization. METHODS: This prospective study included seronegative patients (VZV-IgG ≤200 mIU/ml) and patients who had previously received only a single dose of VZV vaccine...
March 2, 2018: Pediatric Rheumatology Online Journal
Babak Pourakbari, Korosh Yousefi, Shima Mahmoudi, Reihaneh Hosseinpour Sadeghi, Setareh Mamishi
Mycobacterium tuberculosis remains as a vital threat to global health and its diagnosis is still complicated. Since there is no gold standard for the diagnosis of latent tuberculosis infection (LTBI), its diagnosis routinely relies on measurement of host immune responses to M. tuberculosis antigens using the tuberculin skin test (TST) and Interferon-Ƴ release assays (IGRAs). The aim of this study was to evaluate LTBI among hospitalized children and their patents/guardians as general populations in Children Medical Center, an Iranian referral hospital...
February 28, 2018: Infectious Disorders Drug Targets
Neeraj Raizada, Sunil D Khaparde, Virender Singh Salhotra, Raghuram Rao, Aakshi Kalra, Soumya Swaminathan, Ashwani Khanna, Kamal Kishore Chopra, M Hanif, Varinder Singh, K R Umadevi, Sreenivas Achuthan Nair, Sophie Huddart, C H Surya Prakash, Shalini Mall, Pooja Singh, B K Saha, Claudia M Denkinger, Catharina Boehme, Sanjay Sarin
BACKGROUND: Diagnosis of TB in children is challenging, and is largely based on positive history of contact with a TB case, clinical and radiological findings, often without microbiological confirmation. Diagnostic efforts are also undermined by challenges in specimen collection and the limited availability of high sensitivity, rapid diagnostic tests that can be applied with a quick turnaround time. The current project was undertaken in four major cities of India to address TB diagnostic challenges in pediatric population, by offering free of cost Xpert testing to pediatric presumptive TB cases, thereby paving the way for better TB care...
2018: PloS One
Mark P Nicol, Lesley Workman, Margaretha Prins, Lindy Bateman, Yonas Ghebrekristos, Silindile Mbhele, Claudia M Denkinger, Heather J Zar
We determined the accuracy of the new Xpert MTB/RIF Ultra assay for diagnosis of pulmonary tuberculosis in children, using banked induced sputum. Sensitivity and specificity were 75.3% and 96.9% compared with a culture result from the same specimen. Of those children with microbiologically confirmed TB (positive culture, Xpert or Ultra), Xpert detected 63.2%, Ultra 73.7% and culture 82.9.
February 22, 2018: Pediatric Infectious Disease Journal
A Brumwell, E Noyes, S Kulkarni, V Lin, M C Becerra, C M Yuen
OBJECTIVE: To assess available treatment literacy materials for patients undergoing treatment for tuberculosis (TB). DESIGN: We conducted a rapid review by searching the US Centers for Disease Control's Find TB Resources website and the websites of health departments and TB-focused organizations. We included English-language documents intended to educate TB patients about anti-tuberculosis treatment. We evaluated the format, readability, and content of documents, and audience...
March 1, 2018: International Journal of Tuberculosis and Lung Disease
Emanuele Pontali, Dina Visca, Rosella Centis, Lia D'Ambrosio, Antonio Spanevello, Giovanni Battista Migliori
PURPOSE OF REVIEW: Multidrug-resistant (MDR) tuberculosis (TB) and extensively drug-resistant (XDR)-TB epidemics are key obstacles towards TB control and elimination. RECENT FINDINGS: Diagnosis of MDR/XDR-TB is difficult and requires several weeks. New diagnostic tools are being tested and proposed allowing for shorter time to diagnosis and reduced delays in starting an adequate treatment regimen. MDR/XDR-TB treatment strategies are currently on an evolving stage...
February 20, 2018: Current Opinion in Pulmonary Medicine
Agibothu Kupparam Hemanth Kumar, Alok Kumar, Thiruvengadam Kannan, Rakesh Bhatia, Dipti Agarwal, Santosh Kumar, Rajeshwar Dayal, Sheo Pratap Singh, Geetha Ramachandran
We studied the pharmacokinetics of levofloxacin (LFX), pyrazinamide (PZA), ethionamide (ETH) and cycloserine (CS) in children with multidrug-resistant tuberculosis (MDR TB) being treated according to the Revised National TB Control Programme (RNTCP) guidelines in India. This observational, pharmacokinetic study was conducted in 25 children with MDR TB at the Sarojini Naidu Medical College, Agra, India who were being treated with a 24-month daily regimen. Serial blood samples were collected after directly observed administration of drugs...
February 20, 2018: Antimicrobial Agents and Chemotherapy
Lisa M Cranmer, Heather R Draper, Anna M Mandalakas, Soyeon Kim, George McSherry, Emma Krezinski, Joan Coetzee, Charles Mitchell, Sharon Nachman, Mercia van der Linde, Mark F Cotton, Anneke C Hesseling
Young HIV-exposed children are at high risk for TB infection. We performed QuantiFERON®-TB Gold (QFT) among HIV-exposed children in South Africa at enrolment and one year follow-up. The incidence of TB infection was high for HIV+ (11 cases/100 child-years) and HIV-exposed uninfected (HEU) children (15 cases/100 child-years). QFT may identify HIV-exposed children at risk for TB disease progression.
February 16, 2018: Pediatric Infectious Disease Journal
Filipa Guerreiro, Enrica Seravalli, Geert O Janssens, Cees P van de Ven, Marry M van den Heuvel-Eibrink, Bas W Raaymakers
BACKGROUND AND PURPOSE: To assess intra- and inter-fraction motion uncertainties, due to displacements of the tumor bed (TB) and organs at risk (OAR), as well as intra- and inter-fraction patient set-up uncertainties, due to positioning variations, during image-guided radiation therapy (IGRT) in children with Wilms' tumor. MATERIAL AND METHODS: Four-dimensional computed tomography (4D-CT) and daily pre- and post-treatment cone-beam CT (CBCT)-scans of 15 patients (average 4, range 1-8 years) undergoing flank irradiation after nephrectomy were analyzed...
February 19, 2018: Acta Oncologica
Delia Goletti, Meng-Rui Lee, Jann-Yuan Wang, Nicholas Walter, Tom H M Ottenhoff
Tuberculosis (TB) remains a devastating disease, yet despite its enormous toll on global health, tools to control TB are insufficient and often outdated. TB Biomarkers (TB-BM) would constitute extremely useful tools to measure infection status and predict outcome of infection, vaccination or therapy. There are several types of TB-BM: Correlate of Infection; Correlate of TB Disease; Correlate of Increased Risk of Developing Active TB Disease; Correlate of the Curative Response to Therapy; and Correlate of Protection (CoP)...
February 18, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
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