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https://www.readbyqxmd.com/read/29142046/quantitative-analysis-of-interferon-%C3%AE-release-assay-response-in-children-with-latent-and-active-tuberculosis
#1
Giulia Lombardi, Roberta Petrucci, Ilaria Corsini, Maria Letizia Bacchi Reggiani, Francesca Visciotti, Filippo Bernardi, Maria Paola Landini, Salvatore Cazzato, Paola Dal Monte
The use of interferon-γ (IFN-γ) release assays (IGRAs) for the diagnosis of tuberculosis (TB) infection in children is still under debate because of concerns about their immature immune response.The aim of this study was to investigate quantitative values of QuantiFERON®-TB Gold In-Tube (QFT-IT), a commercially available IGRA, in a large cohort of children screened for TB infection.A retrospective analysis was conducted on samples from 517 children aged 0-14 years old at the Pediatric Unit of S. Orsola-Malpighi University Hospital of Bologna (Italy); quantitative responses to QFT-IT stimuli were analyzed according to diagnosis and age...
November 15, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29140996/childhood-tuberculosis-is-associated-with-decreased-abundance-of-t-cell-gene-transcripts-and-impaired-t-cell-function
#2
Cheryl Hemingway, Maurice Berk, Suzanne T Anderson, Victoria J Wright, Shea Hamilton, Hariklia Eleftherohorinou, Myrsini Kaforou, Greg M Goldgof, Katy Hickman, Beate Kampmann, Johan Schoeman, Brian Eley, David Beatty, Sandra Pienaar, Mark P Nicol, Michael J Griffiths, Simon J Waddell, Sandra M Newton, Lachlan J Coin, David A Relman, Giovanni Montana, Michael Levin
The WHO estimates around a million children contract tuberculosis (TB) annually with over 80 000 deaths from dissemination of infection outside of the lungs. The insidious onset and association with skin test anergy suggests failure of the immune system to both recognise and respond to infection. To understand the immune mechanisms, we studied genome-wide whole blood RNA expression in children with TB meningitis (TBM). Findings were validated in a second cohort of children with TBM and pulmonary TB (PTB), and functional T-cell responses studied in a third cohort of children with TBM, other extrapulmonary TB (EPTB) and PTB...
2017: PloS One
https://www.readbyqxmd.com/read/29140946/comparison-of-the-quantiferon-tb-gold-in-tube-assay-with-tuberculin-skin-test-for-the-diagnosis-of-latent-tuberculosis-infection-among-hiv-infected-and-uninfected-children
#3
Walter Dehority, Rolando M Viani, Maria Rosario G Araneta, Graciano Lopez, Stephen A Spector
BACKGROUND: Diagnosis of latent tuberculosis infection (LTBI) is facilitated by tuberculin skin testing (TST) or interferon-gamma release assays such as the QuantiFERON TB Gold In-Tube (QTF-GIT) assays. Limited data exist on the utility of interferon-gamma release assays in HIV-infected children, which may be falsely negative due to immunosuppression. METHODS: A cross-sectional study comparing TST to QTF-GIT for the diagnosis of suspected LTBI was performed in children in Tijuana, Mexico, and in San Diego, California...
December 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29140933/t-spot-tb%C3%A2-performance-in-routine-pediatric-practice-in-a-low-tb-burden-setting
#4
Anna M Mandalakas, Heather Y Highsmith, Nadine M Harris, Anna Pawlicka, H Lester Kirchner
BACKGROUND: The T-SPOT.TB, an interferon-γ release assay (IGRA), is an indirect test of Mycobacterium tuberculosis infection. Due to sparse and conflicting evidence, IGRA use is limited in young and HIV-infected children. We determined the prevalence of invalid, borderline, positive, and negative results and associations with key demographic variables during routine pediatric use in a TB low-burden setting. METHODS: For pediatric samples received at Oxford Diagnostic Laboratories from 2010-2015, the associations between initial test outcome and demographics were estimated by bivariate analysis and logistic regression...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29136358/is-secretion-of-ifn-gamma-in-response-to-mycobacterium-tuberculosis-antigens-in-youngest-children-sufficient-to-play-a-role-in-tb-diagnostics
#5
Teresa Bielecka, Anna Komorowska-Piotrowska, Katarzyna Krenke, Wojciech Feleszko, Marek Kulus
OBJECTIVES: To assess whether children ≤5 years of age, produce sufficient amounts of interferon gamma (IFN-ɣ) in response to phytohaemagglutinin (mitogen), and Mycobacterium tuberculosis antigens (TB antigens) in the QuantiFERON-TB Gold in-Tube test (QFT-GIT), (Cellestis Ltd., Australia). WORKING HYPOTHESIS: Is TB-antigen-induced IFN-ɣ response in children ≤5 years sufficient to consider QFT-GIT a possible tool for TB diagnostics? Study design, patient-subject selection, and methods: We recruited children 0-17 years old suspected of TB infection to this cross-sectional study, in whom QFT-GIT and TST were performed...
November 14, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29133560/levofloxacin-population-pharmacokinetics-in-south-african-children-treated-for-multidrug-resistant-tuberculosis
#6
Paolo Denti, Anthony J Garcia-Prats, Heather R Draper, Lubbe Wiesner, Jana Winckler, Stephanie Thee, Kelly E Dooley, Rada M Savic, Helen M McIlleron, H Simon Schaaf, Anneke C Hesseling
Background: Levofloxacin is increasingly used in the treatment of multidrug-resistant tuberculosis (MDR-TB). There are limited paediatric pharmacokinetic data to inform dose selection for children.Methods: Children routinely receiving levofloxacin (250 mg adult tablets) for MDR-TB prophylaxis or disease in Cape Town, South Africa, underwent pharmacokinetic sampling following a 15 or 20 mg/kg dose, given as whole tablet(s) or crushed, orally, or by nasogastric tube. Pharmacokinetic parameters were estimated using non-linear mixed effects modelling...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29133558/pharmacokinetics-and-drug-drug-interactions-of-lopinavir-ritonavir-administered-with-first-and-second-line-antituberculosis-drugs-in-hiv-infected-children-treated-for-multidrug-resistant-tuberculosis
#7
Louvina E van der Laan, Anthony J Garcia-Prats, H Simon Schaaf, Tjokosela Tikiso, Lubbe Wiesner, Mine de Kock, Jana Winckler, Jennifer Norman, Helen McIlleron, Paolo Denti, Anneke C Hesseling
Background Lopinavir/ritonavir forms the backbone of current first-line antiretroviral regimens in young HIV-infected children. As multidrug-resistant (MDR) tuberculosis (TB) frequently occurs in young children in high-burden TB settings, it is important to identify potential interactions between MDR-TB treatment and lopinavir/ritonavir. We describe the pharmacokinetics of and potential drug-drug interactions between lopinavir/ritonavir and routine drugs used for MDR-TB treatment in HIV-infected children.Methods A combined population pharmacokinetic model was developed to jointly describe the pharmacokinetics of lopinavir and ritonavir in 32 HIV-infected children (16 on MDR-TB treatment with combinations of high-dose isoniazid, pyrazinamide, ethambutol, ethionamide, terizidone, a fluoroquinolone, and amikacin: and 16 without TB), who were established on a lopinavir/ritonavir-containing antiretroviral regimen...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29132287/a-qualitative-analysis-of-the-barriers-to-antiretroviral-therapy-initiation-among-children-2-to-18-months-of-age-in-swaziland
#8
Charisse V Ahmed, Pauline Jolly, Luz Padilla, Musa Malinga, Chantal Harris, Nobuhle Mthethwa, Inessa Ba, Amy Styles, Sarah Perry, Raina Brooks, Florence Naluyinda-Kitabire, Makhosini Mamba, Peter Preko
HIV/AIDS remains one of the leading causes of death among children under 5 years old in Swaziland. Although studies have shown that early initiation of infants and children diagnosed with HIV on antiretroviral therapy (ART) significantly reduces mortality, many children do not initiate ART until the later stages of disease. This study was designed to collect qualitative data from mothers and caregivers of HIV-positive children to identify the barriers to ART initiation. Focus group discussion (FGD) sessions were conducted in siSwati between July and September 2014 among caregivers of aged children 2-18 months in Swaziland who did or did not initiate ART between January 2011 and December 2012 after HIV DNA PCR-positive diagnosis of the infants...
December 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/29132283/predictors-of-survival-among-hiv-positive-children-on-art-in-swaziland
#9
Patrick Shabangu, Andy Beke, Samuel Manda, Nobuhle Mthethwa
The objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively...
December 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/29126100/using-reports-of-latent-tuberculosis-infection-among-young-children-to-identify-tuberculosis-transmission-in-new-york-city-2006-2012
#10
Jennifer Sanderson Slutsker, Lisa Trieu, Aldo Crossa, Shama Desai Ahuja
Young children with latent tuberculosis infection (LTBI) indicate recent TB transmission. We reviewed surveillance reports of children with LTBI to assess whether more follow-up is needed to prevent TB among this high-risk population. All children <5 years reported to the New York City Department of Health from 2006-2012 were abstracted from the TB Registry to identify those with LTBI. Potential source cases were identified; defined as any infectious TB case diagnosed in the 2 years before a child was reported and whose residence was within <0...
November 8, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29121953/risk-of-tuberculosis-among-alabama-children-and-adolescents-treated-with-tumor-necrosis-factor-inhibitors-a-retrospective-study
#11
Matthew L Stoll, James Aaron Grubbs, Timothy Beukelman, Melissa L Mannion, Traci W Jester, Randy Q Cron, Marilyn J Crain
BACKGROUND: Tumor Necrosis Factor inhibitors (TNFi) have dramatically improved the outlook for patients with inflammatory arthritides and bowel disease (IBD), but are associated with increased infection risks, including tuberculosis (TB). Pediatric inflammatory diseases are uncommon, and the risk of TB in children taking TNFi remains unclear. The objective of this study was to report the incidence of TB disease among TNFi recipients at a single pediatric medical center serving most of Alabama compared to that of the general population of Alabama children...
November 9, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29116637/epidemiology-of-drug-resistant-tuberculosis
#12
Anna S Dean, Helen Cox, Matteo Zignol
As we move into the era of the Sustainable Development Goals (SDGs), the World Health Organization (WHO) has developed the End TB strategy 2016-2035 with a goal to end the global epidemic of tuberculosis (TB) by 2035. Achieving the targets laid out in the Strategy will require strengthening of the whole TB diagnosis and treatment cascade, including improved case detection, the establishment of universal drug susceptibility testing and rapid treatment initiation. An estimated 3.9% of new TB cases and 21% of previously treated cases had rifampicin-resistant (RR) or multidrug-resistant (MDR) TB in 2015...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29108007/drop-out-from-the-tuberculosis-contact-investigation-cascade-in-a-routine-public-health-setting-in-urban-uganda-a-prospective-multi-center-study
#13
Mari Armstrong-Hough, Patricia Turimumahoro, Amanda J Meyer, Emmanuel Ochom, Diana Babirye, Irene Ayakaka, David Mark, Joseph Ggita, Adithya Cattamanchi, David Dowdy, Frank Mugabe, Elizabeth Fair, Jessica E Haberer, Achilles Katamba, J Lucian Davis
SETTING: Seven public tuberculosis (TB) units in Kampala, Uganda, where Uganda's national TB program recently introduced household contact investigation, as recommended by 2012 guidelines from WHO. OBJECTIVE: To apply a cascade analysis to implementation of household contact investigation in a programmatic setting. DESIGN: Prospective, multi-center observational study. METHODS: We constructed a cascade for household contact investigation to describe the proportions of: 1) index patient households recruited; 2) index patient households visited; 3) contacts screened for TB; and 4) contacts completing evaluation for, and diagnosed with, active TB...
2017: PloS One
https://www.readbyqxmd.com/read/29108003/schistosoma-other-helminth-infections-and-associated-risk-factors-in-preschool-aged-children-in-urban-tanzania
#14
Khadija Said, Jerry Hella, Stefanie Knopp, Tatu Nassoro, Neema Shija, Fatma Aziz, Francis Mhimbira, Christian Schindler, Upendo Mwingira, Anna M Mandalakas, Karim Manji, Marcel Tanner, Jürg Utzinger, Lukas Fenner
BACKGROUND: Despite the high prevalence of helminth infections among preschool-aged children, control programs in sub-Saharan countries primarily focus on school-aged populations. We assessed the prevalence of helminth infections and determined risk factors for infection among preschool-aged children in the urban setting of Dar es Salaam, Tanzania. METHODOLOGY: Starting in October 2015, we conducted a 12-month prospective study among tuberculosis (TB)-exposed children under the age of 5 years and unexposed controls from neighboring households...
November 6, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29048512/excellent-treatment-outcomes-in-children-treated-for-tuberculosis-under-routine-operational-conditions-in-cape-town-south-africa
#15
Muhammad Osman, Kevin Lee, Karen Du Preez, Rory Dunbar, Anneke C Hesseling, James A Seddon
Background: Tuberculosis (TB) remains a leading cause of death in children globally. It is recognized that human immunodeficiency virus (HIV) infection increases the risk of developing TB, but our understanding of the impact of HIV on risk of mortality for children treated for TB is limited. We aimed to identify predictors of mortality in children treated for drug-susceptible TB. Methods: A retrospective analysis of all children (<15 years of age) routinely treated between 2005 and 2012 for drug-susceptible TB in Cape Town was conducted using the programmatic electronic TB treatment database...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29047424/drug-resistant-tuberculosis-among-children-china-2006-2015
#16
Ning-Ning Tao, Xiao-Chun He, Xian-Xin Zhang, Yao Liu, Chun-Bao Yu, Huai-Chen Li
Microbial drug resistance has become a major public health concern worldwide. To acquire epidemiologic data on drug-resistant tuberculosis (DR TB) among children, a major cause of illness and death for this population, we conducted a retrospective study of 2006-2015 data from 36 TB prevention and control institutions in Shandong Province, China. A total of 14,223 new TB cases, among which children (<18 years of age) accounted for only 5.5%, were caused by culture-confirmed Mycobacterium tuberculosis. Among children with TB, 18...
November 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29042376/protocol-for-a-cohort-study-of-adolescent-mental-health-service-users-with-a-nested-cluster-randomised-controlled-trial-to-assess-the-clinical-and-cost-effectiveness-of-managed-transition-in-improving-transitions-from-child-to-adult-mental-health-services-the
#17
Swaran P Singh, Helena Tuomainen, Giovanni de Girolamo, Athanasios Maras, Paramala Santosh, Fiona McNicholas, Ulrike Schulze, Diane Purper-Ouakil, Sabine Tremmery, Tomislav Franić, Jason Madan, Moli Paul, Frank C Verhulst, Gwen C Dieleman, Jane Warwick, Dieter Wolke, Cathy Street, Claire Daffern, Priya Tah, James Griffin, Alastair Canaway, Giulia Signorini, Suzanne Gerritsen, Laura Adams, Lesley O'Hara, Sonja Aslan, Frédérick Russet, Nikolina Davidović, Amanda Tuffrey, Anna Wilson, Charlotte Gatherer, Leanne Walker
INTRODUCTION: Disruption of care during transition from child and adolescent mental health services (CAMHS) to adult mental health services may adversely affect the health and well-being of service users. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare) study evaluates the longitudinal course and outcomes of adolescents approaching the transition boundary (TB) of their CAMHS and determines the effectiveness of the model of managed transition in improving outcomes, compared with usual care...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29028800/spatial-distribution-of-extensively-drug-resistant-tuberculosis-xdr-tb-patients-in-kwazulu-natal-south-africa
#18
Thandi Kapwata, Natashia Morris, Angela Campbell, Thuli Mthiyane, Primrose Mpangase, Kristin N Nelson, Salim Allana, James C M Brust, Pravi Moodley, Koleka Mlisana, Neel R Gandhi, N Sarita Shah
BACKGROUND: KwaZulu-Natal province, South Africa, has among the highest burden of XDR TB worldwide with the majority of cases occurring due to transmission. Poor access to health facilities can be a barrier to timely diagnosis and treatment of TB, which can contribute to ongoing transmission. We sought to determine the geographic distribution of XDR TB patients and proximity to health facilities in KwaZulu-Natal. METHODS: We recruited adults and children with XDR TB diagnosed in KwaZulu-Natal...
2017: PloS One
https://www.readbyqxmd.com/read/29028662/stool-xpert-mtb-rif-and-urine-lipoarabinomannan-lam-for-diagnosing-tuberculosis-in-hospitalized-hiv-infected-children
#19
Sylvia M LaCourse, Patricia B Pavlinac, Lisa M Cranmer, Irene N Njuguna, Cyrus Mugo, John Gatimu, Joshua Stern, Judd L Walson, Elizabeth Maleche-Obimbo, Julius Oyugi, Dalton Wamalwa, Grace John-Stewart
BACKGROUND: Tuberculosis (TB) causes substantial morbidity and mortality in HIV-infected children. Sample collection and paucibacillary nature of TB in children makes diagnosis challenging. Rapid diagnostic tools using easily obtained specimens are urgently needed. METHODS: Hospitalized, HIV-infected children ≤12 years enrolled in a randomized controlled trial (NCT02063880) comparing urgent to poststabilization ART initiation in Kenya underwent TB evaluation. At enrollment, sputum or gastric aspirates (GA) were collected for TB culture and Xpert, stool for Xpert, and urine for lateral flow lipoarabinomannan (LAM )...
October 12, 2017: AIDS
https://www.readbyqxmd.com/read/29027495/monitoring-and-managing-antibiotic-resistance-in-refugee-children
#20
Helena C Maltezou, Dana Elhadad, Daniel Glikman
The past decade the Middle East and Southeastern Europe have witnessed an enormous movement of refugees due to the Syrian war and conflicts in Asia and Africa. Although carriage of and infections with multi-drug resistant (MDR) pathogens in refugees have been reported, pediatric data are scarce. Areas covered: MDR bacterial carriage and infections, and MDR-tuberculosis (TB) in refugee children from 2010. Expert commentary: High MDR carriage rates in refugee children are attributed to high pre-civil war MDR rates, war-damaged infrastructure and healthcare systems, and poor hygiene conditions...
October 23, 2017: Expert Review of Anti-infective Therapy
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