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Tb in children

Gurinder Kumar, Vasudev Omprakash Sharma, Khalid Mohamed Mansour Mohamedfaris, Rajendran Nair, Aman Preet Singh Sohal
Differentiated thyroid cancer is a rare disease in children and adolescents and manifests exclusively in the form of papillary thyroid cancer (PTC). We present a rare case of PTC who presented initially with lung symptoms and miliary nodules on chest X-ray. This case emphasises the important differential of miliary mottling of the lungs.A 7-year-old girl presented with history of neck swelling and change in voice for the past 9 months and progressively worsening dyspnoea for 5 months. She was assessed elsewhere and treated with multiple courses of antibiotics without relief, as well as levothyroxine 50 µg daily for new hypothyroidism...
November 15, 2018: Archives of Disease in Childhood. Education and Practice Edition
Eneritz Velasco-Arnaiz, Antoni Soriano-Arandes, Irene Latorre, Neus Altet, José Domínguez, Clàudia Fortuny, Manuel Monsonís, Marc Tebruegge, Antoni Noguera-Julian
BACKGROUND: Available data to assess the optimal diagnostic approach in infants and preschool children at risk of tuberculosis (TB) are limited. METHODS: We conducted a prospective observational study in children younger than 5 years undergoing assessment with both tuberculin skin tests (TST) and QuantiFERON-TB Gold In-Tube (QFT-GIT) assays at 2 tertiary TB units in Barcelona, Spain. RESULTS: A total of 383 children were included. One of 304 participants considered uninfected developed active TB during follow-up {median [interquartile range (IQR)]: 47 [30; 48] months}, compared with none of 40 participants with latent TB infection [follow-up since completion of anti-TB treatment: 42 (32; 45) months]...
December 2018: Pediatric Infectious Disease Journal
Rafael Laniado-Laborín, Kenia Carrera-López, Ana Hernández-Pérez
Several drugs used in the treatment of multidrug-resistant tuberculosis (MDR-TB) have been reported as teratogenic. Treatment of such cases during gestation is disputable. Some experts favor the termination of pregnancy, whereas others suggest reducing the dose of teratogenic drugs or even suspending the regimen during pregnancy. There have been no clinical trials on the subject, but case reports and case series show excellent outcomes for children exposed during pregnancy to second-line agents, indicating that aggressive management of gestational MDR-TB may benefit not only the mother but also the fetus...
June 19, 2018: Turkish Thoracic Journal
Rewa K Choudhary, Kristin M Wall, Irene Njuguna, Patricia B Pavlinac, Sylvia M Lacourse, Vincent Otieno, John Gatimu, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton Wamalwa, Grace John-Stewart, Lisa M Cranmer
BACKGROUND: The blood monocyte-to-lymphocyte ratio (MLR) is associated with active tuberculosis (TB) in adults, but has not been evaluated as a TB diagnostic biomarker in HIV-infected children in whom respiratory sampling is difficult. SETTING: In a cohort of HIV-infected hospitalized Kenyan children initiating antiretroviral therapy, absolute monocyte and lymphocyte counts were determined at enrollment and 4, 12, and 24 weeks thereafter. METHODS: Children were classified as confirmed, unconfirmed, or unlikely pulmonary TB...
October 26, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Laila Parvaresh, Shopna K Bag, Jin-Gun Cho, Neil Heron, Hassan Assareh, Sophie Norton, Stephen Corbett, Ben J Marais
Treatment of latent tuberculosis infection (LTBI) is an important component of strategies to achieve global tuberculosis (TB) elimination, but implementation is rarely monitored. This is a retrospective review of TB contact tracing outcomes at one of the busiest TB clinics in Australia, measured against the Centre for Disease Control and Prevention performance indicators. In total, 45 of 53 (85%) pulmonary TB cases had 171 close contacts, of whom 139 (81%) were evaluated with a tuberculin skin test (TST); 58 of 139 (42%) were positive at baseline...
2018: BMJ Open Respiratory Research
Synne Jenum, Selvam Sumithra, Jesuraj Nelson, Ritz Christian, Hesseling Anneke C, Cardenas Vicky, Lau Esther, Doherty T Mark, Grewal Harleen M S, Vaz Mario
Introduction: Accurate tuberculosis (TB) incidence and optimal surveillance strategies are pertinent to TB vaccine trial design. Infants are a targeted population for new TB vaccines, but data from India, with the highest global burden of TB cases, is limited. Methods: In a population-based prospective trial conducted between November 2006 and July 2008, BCG-vaccinated neonates in South India were enrolled and cluster-randomised to active or passive surveillance...
2018: BMJ Open Respiratory Research
Awewura Kwara, Hongmei Yang, Sampson Antwi, Anthony Enimil, Fizza S Gillani, Albert Dompreh, Antoinette Ortsin, Theresa Opoku, Dennis Bosomtwe, Anima Sarfo, Lubbe Wiesner, Jennifer Norman, Wael A Alghamdi, Taimour Langaee, Charles A Peloquin, Michael H Court, David J Greenblatt
We compared efavirenz pharmacokinetic (PK) parameters in children with TB/HIV coinfection on and off first-line antituberculosis therapy to that in HIV-infected children. Children aged 3 to 14 years old with HIV infection with and without TB were treated with standard efavirenz-based antiretroviral therapy without any efavirenz dose adjustments. The new World Health Organization recommended antituberculosis drugs dosages were used in the co-infected participants. Steady-state efavirenz concentrations after 4 weeks of antiretroviral therapy were measured using validated LC/MS/MS assays...
November 5, 2018: Antimicrobial Agents and Chemotherapy
David Isaacs, Philip N Britton, Henry A Kilham, Shopna Bag, Susan Marks
Although mandatory reporting of suspected child abuse was first introduced over 50 years ago, there are no quantitative studies addressing whether or not it achieves better outcomes for children. We report two cases of maternal infection, one with tuberculosis (TB) and one with human immunodeficiency virus (HIV), where the mothers' failure to attend follow-up appointments raised the possibility of significant harm if their infants were infected. Some health professionals argued strongly that mandatory reporting meant the mothers should be reported to child protection authorities...
November 2018: Journal of Paediatrics and Child Health
Phuong T K Nguyen, Trang T B Thai, Julie Huynh, Ben J Marais
A 5-month-old boy presented with a focal seizure. Disseminated (miliary) tuberculosis (TB) was diagnosed on chest radiograph and TB meningitis was confirmed using Xpert MTB/RIF® . The case represents the first instance of cerebrospinal fluid Xpert MTB/RIF® testing in children in central Viet Nam. Family screening diagnosed the father with sputum smear-positive TB. The mother and a 2-year-old sibling had no symptoms or signs of TB disease and started preventive therapy. Early TB meningitis diagnosis is the single most important factor influencing clinical outcome, but is difficult due to the non-specific signs and symptoms at disease onset...
October 29, 2018: Journal of Clinical Medicine
Kerclin Danielle de Klerk, Steffen Bau, Gunar Günther
Tuberculosis is still one of the most common respiratory diseases in Africa and worldwide and miliary tuberculosis is a regular manifestation of it. Idiopathic pulmonary hemosiderosis is a rare disease entity, presenting in children as well as adults. It is characterized by the triad of recurrent episodes of alveolar hemorrhage, presenting as hemoptysis, iron deficiency anemia and bilateral pulmonary infiltrates seen on chest X-ray. These symptoms and signs can easily be confused for other diseases i.e. miliary tuberculosis, delaying appropriate management...
2018: Pan African Medical Journal
S Sawry, H Moultrie, A Van Rie
SETTING: Out-patient paediatric human immunodeficiency virus (HIV) clinic in Soweto, South Africa. OBJECTIVE: To evaluate the yield of symptom screening for intensified tuberculosis (TB) case finding (ICF) and potential eligibility for isoniazid preventive therapy (IPT) in children living with HIV on antiretroviral treatment (ART). DESIGN: A cohort of 247 children (age 0-8 years) was systematically screened for TB symptoms during the first 2 years of ART...
November 1, 2018: International Journal of Tuberculosis and Lung Disease
S Zawedde-Muyanja, A Nakanwagi, J P Dongo, M P Sekadde, R Nyinoburyo, G Ssentongo, A K Detjen, F Mugabe, J Nakawesi, Y Karamagi, P Amuge, A Kekitiinwa, S M Graham
BACKGROUND: A lack of capacity to diagnose tuberculosis (TB) in children at peripheral health facilities and limited contact screening and management contribute to low case finding in TB-endemic settings. OBJECTIVE: To evaluate the implementation of a pilot project that strengthened diagnosis, treatment and prevention of child TB at peripheral health facilities in Uganda. METHODS: In June 2015, health care workers at peripheral health facilities were trained to diagnose and treat child TB...
November 1, 2018: International Journal of Tuberculosis and Lung Disease
J Villarreal, V Alarcón, E Alarcón-Arrascue, D A J Moore, E Heldal, A Mendoza-Ticona
OBJECTIVE: To characterise childhood tuberculosis (TB) treated with second-line drugs (SLDs) in Lima, Peru. DESIGN: Results for the age groups <5 and 5-14 years were compared and treatment outcomes were assessed in cases reported between 2011 and 2015 from six districts of Lima. RESULTS: Of 96 reported cases, 82 were evaluated. Among these, 59% were boys; the median age was 8 years and 32% were aged <5 years. Contact with a TB case was reported in 82% of cases; 90% were treatment-naïve, 98% had pulmonary localisation and 50% underwent the tuberculin skin test (purified protein derivative), with induration 10 mm in 88%...
November 1, 2018: International Journal of Tuberculosis and Lung Disease
Hongqi Zhang, Qiang Guo, Yunjia Wang, Chaofeng Guo, Mingxing Tang
PURPOSE: The study aimed to evaluate the efficiency of the posterior-only approach using shaped titanium mesh cage for surgical treatment of spinal tuberculosis (TB) in children. METHODS: Between January 2011 and July 2013, 22 children with a single motion spinal segment involved, including 10 with thoracic, 4 with thoracolumbar, and 8 with lumbar, were enrolled in the study. The patients were treated by the posterior-only approach using the shaped titanium mesh cages...
May 2018: Journal of Orthopaedic Surgery
Aklilu Endalamaw, Eshetu Hailesilassie Engeda, Nega Tezera
OBJECTIVES: Be aware of the burden of tuberculosis among high-risk population is important. Three hundred fifty-two children were participated in this study. Survival analysis was conducted. We assessed the incidence of tuberculosis and its predictors in children on ART. RESULTS: Tuberculosis incidence rate in children on ART was 2.63 per 100 person-years. Those children who were on baseline World Health Organization clinical stages 3 and 4 (AHR (adjusted hazard ratio) = 3...
October 20, 2018: BMC Research Notes
Saikou Y Bah, Thorsten Forster, Paul Dickinson, Beate Kampmann, Peter Ghazal
Background: Whole blood expression profiling is a mainstay for delineating differential diagnostic signatures of infection yet is subject to high variability that reduces power and complicates clinical usefulness. To date, confirmatory high confidence expression profiling signatures for clinical use remain uncertain. Here we have sought to evaluate the reproducibility and confirmatory nature of differential expression signatures, comprising molecular and cellular pathways, across multiple international clinical observational studies investigating children and adult whole blood transcriptome responses to tuberculosis (TB)...
2018: Frontiers in Genetics
Salmaan Keshavjee, Farhana Amanullah, Adithya Cattamanchi, Richard Chaisson, Karen M Dobos, Gregory J Fox, Howard E Gendelman, Richard Gordon, Anneke Hesseling, Le Van Hoi, Beate Kampmann, Bavesh Kana, Gopal Khuller, David M Lewinsohn, Deborah A Lewinsohn, Philiana Ling Lin, Lenette Lin Lu, Gary Maartens, Andrew Owen, Marina Protopopova, Jyothi Rengarajan, Eric Rubin, Padmini Salgame, Erwin Schurr, James A Seddon, Susan Swindells, David M Tobin, Zarir Udwadia, Gerhard Walzl, Sudha Srinivasan, Roxana Rustomjee, Payam Nahid
Tuberculosis (TB) has surpassed HIV to become the leading infectious killer of adults globally, causing almost 2 million deaths annually. Although this airborne disease has been treatable since 1948, global rates of TB have dropped less than two percent per year; an estimated 10 million incident cases continue to occur annually, including one million in children. While transmission of active disease is an important driver of the epidemic, the seedbed that feeds the epidemic is the more than two billion people estimated to have TB infection, five to ten percent of whom will progress to active disease during their lifetime...
October 18, 2018: American Journal of Respiratory and Critical Care Medicine
Elizabeth Whittaker, Mark P Nicol, Heather J Zar, Nontobeko G Tena-Coki, Beate Kampmann
In the absence of a more effective vaccine against TB and in the interest of developing one, it is essential to understand immune responses associated with BCG protection. We comprehensively characterized T cell populations in BCG-vaccinated children over time. Blood from 78 healthy, BCG-vaccinated children representing four age groups (<1 yr, ≥1 yr <2 yr, ≥2 yr <5 yr, ≥5 yr), was stimulated in vitro for 24 hours and 6 days with live BCG to induce effector and central memory responses...
October 17, 2018: Scientific Reports
Francesco Di Gennaro, Luigi Pisani, Nicola Veronese, Damiano Pizzol, Valeria Lippolis, Annalisa Saracino, Laura Monno, Michaëla A M Huson, Roberto Copetti, Giovanni Putoto, Marcus J Schultz
Background : Chest ultrasound (CUS) has been shown to be a sensitive and specific imaging modality for pneumothorax, pneumonia, and pleural effusions. However, the role of chest ultrasound in the diagnosis of thoracic tuberculosis (TB) is uncertain. We performed a systematic search in the medical literature to better define the potential role and value of chest ultrasound in diagnosing thoracic tuberculosis. Aim : To describe existing literature with regard to the diagnostic value of chest ultrasound in thoracic tuberculosis...
October 12, 2018: International Journal of Environmental Research and Public Health
Joseph M Kindler, Andrea J Lobene, Kara A Vogel, Berdine R Martin, Linda D McCabe, Munro Peacock, Stuart J Warden, George P McCabe, Connie M Weaver
Context: Insulin resistance is an adverse health outcome that accompanies obesity. Fat mass is negatively associated with bone mass while adjusting for confounders, and insulin resistance might be an intermediary in this relationship. Objective: Determine whether insulin resistance is an intermediary in the relationship between adiposity and bone mass in adolescents. Design: Cross-sectional secondary analysis of baseline data from a previous randomized trial...
October 11, 2018: Journal of Clinical Endocrinology and Metabolism
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