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Tb in children

Yajun Zhang, Yuhong Tao
Pancreatic tuberculosis (TB) is an uncommon form of extrapulmonary TB and represents a diagnostic challenge for physicians. Pancreatic TB presents with nonspecific signs and symptoms and may mimic malignancy. However, pancreatic TB rarely occurs in children. Here, we present a case of a 5-year-old girl with pancreatic TB and markedly elevated serum cancer antigen- (CA-) 125 levels, thus raising the suspicion of malignancy, but positivity for Mycobacterium tuberculosis DNA was noted. The patient recovered after being administered standard antitubercular therapy for one year...
2018: Case Reports in Pediatrics
V Ollier, F Antoun, G Thouvenin, A Faye, I Kone-Paut, G Benoist, D Antoine, C Charlois, C Delacourt
Early screening is recommended in children exposed to a contagious case of tuberculosis (TB), to prevent rapid progression to active TB. The aim of this study was to evaluate the percentage of potentially preventable cases of pediatric TB stemming from inadequate screening. The data gathered on children aged 0 to 10 years, who were evaluated by the Paris Center for TB Control (CLAT75) between January 2009 and December 2013, were extracted and retrospectively analyzed. French National Guidelines for screening were used as reference...
September 13, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Toyin Omotayo Togun, Emily MacLean, Beate Kampmann, Madhukar Pai
INTRODUCTION: As studies of biomarkers of tuberculosis (TB) disease provide hope for a simple, point-of-care test, we aimed to synthesize evidence on biomarkers for diagnosis of TB in children and compare their accuracy to published target product profiles (TPP). METHODS: We conducted a systematic review of biomarkers for diagnosis of pulmonary TB in exclusively paediatric populations, defined as age less than 15 years. PubMed, EMBASE and Web of Science were searched for relevant publications from January 1, 2000 to November 27, 2017...
2018: PloS One
Kathirvel Maruthai, Mahadevan Subramanian
Background: Investigation of DNA methylation in Alu repetitive elements (REs) was shown to be a promising field to explore transcriptional changes in human genome under disease condition. To scrutinize the association between Alu methylation and tuberculosis (TB) disease in children, the difference in Alu DNA methylation level was compared with healthy controls. Methods: Whole-blood genomic DNA from 36 TB-infected children and 32 healthy controls was isolated, and the level of Alu repeat DNA methylation was examined by methylation-specific polymerase chain reaction...
July 2018: International Journal of Mycobacteriology
Charlotte C Heuvelings, Patrick F Greve, Sophia G de Vries, Benjamin Jelle Visser, Sabine Bélard, Saskia Janssen, Anne L Cremers, René Spijker, Elizabeth Shaw, Ruaraidh A Hill, Alimuddin Zumla, Andreas Sandgren, Marieke J van der Werf, Martin Peter Grobusch
OBJECTIVE: To determine which service models and organisational structures are effective and cost-effective for delivering tuberculosis (TB) services to hard-to-reach populations. DESIGN: Embase and MEDLINE (1990-2017) were searched in order to update and extend the 2011 systematic review commissioned by National Institute for Health and Care Excellence (NICE), discussing interventions targeting service models and organisational structures for the identification and management of TB in hard-to-reach populations...
September 8, 2018: BMJ Open
Jessica L Elf, Aarti Kinikar, Sandhya Khadse, Vidya Mave, Nishi Suryavanshi, Nikhil Gupte, Vaishali Kulkarni, Sunita Patekar, Priyanka Raichur, Mandar Paradkar, Vandana Kulkarni, Neeta Pradhan, Patrick N Breysse, Amita Gupta, Jonathan E Golub
OBJECTIVES: Household air pollution (HAP) is a risk factor for respiratory disease, however has yet to be definitively associated with tuberculosis (TB). We aimed to assess the association between HAP and TB. METHODS: A matched case-control study was conducted among adult women and children patients with TB and healthy controls matched on geography, age and sex. HAP was assessed using questionnaires for pollution sources and 24-hour household concentrations of particulate matter <2...
September 7, 2018: Occupational and Environmental Medicine
Alexandra Duque-Silva, Varsha Hampole, Yi-Ning Cheng, Jennifer Flood, Pennan M Barry
Background: Our goal was to describe the characteristics and posttreatment outcomes of pediatric patients with central nervous system (CNS) tuberculosis (TB) and to identify factors associated with poor outcome. Methods: We included children aged 0 to 18 years with CNS TB reported to the California TB registry between 1993 and 2011. Demographics, clinical characteristics, severity of disease at presentation (Modified Medical Research Council stage I, II, or III [III is most severe]), treatment, and outcomes during the year after treatment completion were abstracted systematically from the medical and public health records...
September 4, 2018: Journal of the Pediatric Infectious Diseases Society
P Méndez-Samperio
Tuberculosis (TB) is an important infectious disease worldwide. Currently, Bacillus Calmette-Guérin (BCG) remains the only TB vaccine licensed for human use. This TB vaccine is effective in protecting children against severe military TB but offers variable protective efficacy in adults. Therefore, new vaccines against TB are needed to overcome this serious disease. At present, around 14 TB vaccine candidates are in different phases of clinical trials. These TB vaccines in clinical evaluation can be classified into two groups including preventive pre- and post-exposure vaccines: subunit vaccines (attenuated viral vectors or adjuvanted fusion proteins), and whole-cell vaccines (genetically attenuated Mycobacterium tuberculosis (M...
August 27, 2018: Scandinavian Journal of Immunology
Xiaoyun Gou, Lingli Pan, Fajuan Tang, Hu Gao, Dongqiong Xiao
BACKGROUND: Vitamin D deficiency (VDD) has been implicated in the pathogenesis of tuberculosis (TB), but most studies have not reported a significant association. We conducted a meta-analysis to explore the association between vitamin D status and TB in children. METHODS: Web of Science, Ovid Medline, and EMBASE were searched for studies in English that discussed vitamin D status and TB in children before January 22, 2018. RESULTS: From the 585 initially identified studies, we selected those that addressed an association between vitamin D status and TB according to our preselected inclusion criteria...
August 2018: Medicine (Baltimore)
Francine Mwayuma Birungi, Brian van Wyk, Jeannine Uwimana, Joseph Ntaganira, Stephen Michael Graham
Introduction: To report on the diagnostic yield using the Xpert MTB/RIF assay on gastric lavage samples from children (<15 years) who were household contacts of tuberculosis (TB) cases in Kigali, Rwanda. Methods: A cross-sectional study was conducted among 216 child contacts of index cases with sputum smear-positive TB over a 7 month period, from 1st August 2015 to 29th February 2016. Child contacts with tuberculosis-related symptoms or abnormal chest X-ray had sputum collected by gastric lavage on two consecutive days and samples were examined by smear microscopy, Xpert MTB/RIF assay and solid culture...
2018: Pan African Medical Journal
Lisa Frigati, Adrie Bekker, Silvia Stroebele, Pierre Goussard, H Simon Schaaf
BACKGROUND: Little is known about the course and management of perinatal tuberculosis (TB). We describe the presentation, medical and surgical management of culture-confirmed TB in infants younger than 3 months of age. METHODS: We conducted a retrospective study including all infants younger than 3 months of age with culture-confirmed TB admitted to Tygerberg Hospital, Cape Town, South Africa from March 2003 through June 2015. RESULTS: During the study period, 106 of 2017 (5%) children younger than 13 years of age with culture-confirmed TB were infants younger than 3 months of age...
August 27, 2018: Pediatric Infectious Disease Journal
Giulia Rodari, G Scuvera, F M Ulivieri, E Profka, F Menni, V Saletti, S Esposito, S Bergamaschi, E Ferrante, C Eller-Vainicher, S Esposito, M Arosio, C Giavoli
Bone density impairment represents an established complication in adults with neurofibromatosis type 1, while few data exist in the pediatric population. Age- and gender-adjusted bone mass decreases with age and pubertal development, identifying childhood as the best time frame to introduce prevention strategies aiming at peak bone mass achievement. PURPOSE: The present study aims at evaluating bone mineral density (BMD) in a population of children with neurofibromatosis type I (NF-1), with particular focus on changes occurring during growth and pubertal development...
August 27, 2018: Archives of Osteoporosis
Mabrouka A Altowati, Sheila Shepherd, Paraic McGrogan, Richard K Russell, S Faisal Ahmed, Sze Choong Wong
BACKGROUND/AIMS: There is limited information on the impact of recombinant human growth hormone (rhGH) on the muscle-bone unit in children with Crohn's disease (CD). In this pilot study, we report on the effects of rhGH on bone formation, dual-energy X-ray absorptiometry (DXA) total body (TB) bone mineral density adjusted for height and lumbar spine (LS) bone mineral apparent density (BMAD), and body composition. METHODS: Prospective study of 8 children with CD (6 male), aged 14...
August 27, 2018: Hormone Research in Pædiatrics
Minnie John, Aditya Chhikara, Deepthi M John, Nayaab Khawar, Brande Brown, Pramod Narula
BACKGROUND In 2017, in New York City (NYC), 86% of the cases of tuberculosis (TB) occurred in patients who were born outside the United States (US). This case report illustrates the importance of the use of the tuberculin skin test (TST), and other tests for TB infection (TTBI), in screening high-risk groups, the challenges of diagnosing TB in young children, and highlights the importance of preventing a delay in the diagnosis of TB in family members. CASE REPORT Following a routine TST in an asymptomatic 10-year-old girl, a diagnosis of TB was made, which was confirmed on chest X-ray (CXR) and by the presence of acid-fast bacilli (AFB) in the sputum...
August 24, 2018: American Journal of Case Reports
Ethel D Weld, Kelly E Dooley
Children and pregnant and postpartum women suffer an undue burden of HIV-associated tuberculosis (TB), but data are lacking on key aspects of their complex management. Often excluded from clinical trials, they are left with limited options for HIV-TB co-treatment. This review will focus on pharmacologic aspects of the treatment of HIV-TB coinfection in the special populations of children and pregnant and postpartum women. Pharmacogenomic considerations, rational dosing, Drug-Drug Interactions (DDIs), safety, Immune Reconstitution Inflammatory Syndrome (IRIS), and ethical and policy aspects of the inclusion of special populations in research will be surveyed...
August 23, 2018: Clinical Pharmacology and Therapeutics
Lindsay A Hatzenbuehler, Jeffrey R Starke
Identifying and treating children with tuberculosis (TB) infection in both low and high-TB burden settings will decrease the incidence of TB disease worldwide. Areas covered: This review covers each of the available TB infection treatment options for children based on effectiveness, safety, tolerability and treatment completion rates. Six to 9 months of daily administered isoniazid is no longer the treatment of choice for many children with TB infection. Shorter, rifamycin based, TB infection treatment regimens are effective, safe and easier for children to complete...
September 7, 2018: Expert Review of Anti-infective Therapy
P Adamczyk, M Szczepanska, W Pluskiewicz
Two methods of skeletal status assessment-quantitative ultrasound (QUS) and densitometry (DXA)-were applied and compared in a group of children with different renal disorders. Skeletal assessments in children with different renal conditions should rather not be based on a single diagnostic tool. Lumbar spine DXA is very effective to reveal disturbances secondary to glucocorticoids, whereas total body DXA and QUS are both better in identification of disturbances related to decreased GFR. INTRODUCTION: The aim of the study was to evaluate the skeletal status in children in different stages of chronic kidney disease (CKD) or treated with glucocorticoids, using either densitometry (DXA) or quantitative ultrasound (QUS) methods...
August 20, 2018: Osteoporosis International
Maria Korzeniewska-Koseła
AIM OF THE STUDY: To evaluate the main features of TB epidemiology in 2016 in Poland and to compare with the situation in the EU/EEA countries. METHODS: Analysis of case- based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2016, data from National Institute of Public Health- National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for Disease Prevention and Control/WHO Regional Office for Europe...
2018: Przegla̧d Epidemiologiczny
Christopher N Carender, Craig Chike Akoh, Heather R Kowalski
Mycobacterium tuberculosis monoarthritis is a rare form of TB, occurring in 1-2% of cases in the United States. Delays in definitive diagnosis and subsequent treatment are common. While case reports of tuberculous arthritis have been presented in international literature, there is a relative paucity of literature from within the United States. Given the difficulty in diagnosis and adverse outcomes of delayed diagnosis, we present the case of an 11-year-old otherwise healthy male with isolated monoarticular TB septic arthritis of the right knee...
2018: Iowa Orthopaedic Journal
Erkan Çakır, Ali Özdemir, Hayrettin Daşkaya, Tarık Umutoğlu, Mine Yüksel
Çakır E, Özdemir A, Daşkaya H, Umutoğlu T, Yüksel M. The value of nasopharyngeal aspirate, gastric aspirate and bronchoalveolar lavage fluid in the diagnosis of childhood tuberculosis. Turk J Pediatr 2018; 60: 10-13. Pulmonary tuberculosis (TB) is an important cause of morbidity and mortality especially in developing countries. A definitive microbiologic confirmation of Mycobacterium tuberculosis is important in the diagnosis of childhood TB. We aimed to compare the diagnostic value of nasopharyngeal aspirate (NPA), gastric aspirate (GA) and bronchoalveolar lavage (BAL) specimens in children with highly suspected pulmonary tuberculosis (TB)...
2018: Turkish Journal of Pediatrics
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