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Childhood TB

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
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
Liina Mansukoski, Vitale Stefano Sparacello
There is little research on how individuals suffering from tuberculosis may differ from those not infected in terms of overall skeletal morphology. Tuberculosis was endemic in 19th and early 20th century Finland making documented skeletal collections of Finns ideal to study effects of the disease on bone. The present study compares long bone cross-sectional total area between individuals who died of tuberculosis and those with another recorded cause of death in a Finnish sample. Adult male individuals (N = 105) were selected for analysis...
March 2018: International Journal of Paleopathology
Andrew J Brent, Christopher Nyundo, Joyce Langat, Caroline Mulunda, Joshua Wambua, Evasius Bauni, Joyce Sande, Kate Park, Thomas N Williams, Charles R J Newton, Michael Levin, J Anthony G Scott
No abstract text is available yet for this article.
March 2018: Emerging Infectious Diseases
Natalie E Nieuwenhuizen, Stefan H E Kaufmann
Tuberculosis (TB), caused by the intracellular bacterium Mycobacterium tuberculosis (Mtb), remains a major health threat. A live, attenuated mycobacterium known as Bacille Calmette-Guérin (BCG), derived from the causative agent of cattle TB, Mycobacterium bovis , has been in clinical use as a vaccine for 90 years. The current incidence of TB demonstrates that BCG fails to protect sufficiently against pulmonary TB, the major disease manifestation and source of dissemination. The protective efficacy of BCG is on average 50% but varies substantially with geographical location and is poorer in those with previous exposure to mycobacteria...
2018: Frontiers in Immunology
Arghya Das, Shampa Anupurba, Om P Mishra, Tuhina Banerjee, Rajneesh Tripathi
Introduction: Childhood tuberculosis (TB) is now a global priority. With the advent of Xpert MTB/RIF, more TB cases in children are being reported. This study was undertaken to evaluate the performance of Xpert in diagnosis of pulmonary and extra-pulmonary TB in children. Methods: Specimens from 171 suspected TB cases in children aged <15 years were tested with Xpert, culture and smear microscopy in the Department of Microbiology, Institute of Medical Sciences, India...
February 9, 2018: Journal of Tropical Pediatrics
Conor Teljeur, Patrick S Moran, Patricia Harrington, Karina Butler, Brenda Corcoran, Joan O'Donnell, Cara Usher, Darina O'Flanagan, Kevin Connolly, Máirín Ryan
BACKGROUND: In Western Europe, currently only Ireland and Portugal continue to provide universal neonatal BCG vaccination programmes, despite not being considered as high TB incidence countries. Other European countries only vaccinate infants considered at high risk of contracting TB. We evaluated the cost-effectiveness of selective BCG vaccination compared to strategies of universal and no vaccination. METHODS: An economic model was used to simulate a cohort from birth to life expectancy, taking the perspective of the publicly-funded healthcare system...
February 9, 2018: Pediatric Infectious Disease Journal
Senjuti Kabir, Mohammad Khaja Mafij Uddin, Mohammod Jobayer Chisti, Tilka Fannana, Mohammad Enamul Haque, Muhammad Reaj Uddin, Sayera Banu, Tahmeed Ahmed
Better methods are warranted for precise childhood tuberculosis (TB) detection. We compared different laboratory tests and evaluated PCR IS6110 in Mycobacterium tuberculosis (MTB) detection among clinically diagnosed child TB patients.
January 29, 2018: International Journal of Infectious Diseases: IJID
Pia Steigler, Naomi J Daniels, Tim R McCulloch, Brin M Ryder, Sarah K Sandford, Joanna R Kirman
The tuberculosis (TB) vaccine bacille Calmette-Guérin (BCG) prevents disseminated childhood TB, however fails to protect against the more prevalent pulmonary TB. Limited understanding of the immune response to Mycobacterium tuberculosis, the causative agent of TB, has hindered development of improved vaccines. Although memory CD4 T cells are considered the main mediators of protection against TB, recent studies suggest there are other key subsets that contribute to anti-mycobacterial immunity. To that end, innate cells may be involved in the protective response...
January 9, 2018: Immunology and Cell Biology
M Loveday, B Sunkari, I Master, A Daftary, V Mehlomakulu, S Hlangu, B J Marais
SETTING: Referral hospital for drug-resistant tuberculosis (TB) in KwaZulu-Natal, South Africa. OBJECTIVES: We conducted interviews with primary care givers of children admitted with multidrug-resistant TB (MDR-TB) during a 3-month period in 2015 to identify broader household challenges. RESULTS: We interviewed 26 care givers, most of whom were women (85%). Most households had been decimated by TB/MDR-TB and human immunodeficiency virus (HIV) infection, and were dependent upon government grants...
January 1, 2018: International Journal of Tuberculosis and Lung Disease
Looi C Ee, Charlton Noble, Jonathan Fawcett, Geoffrey J Cleghorn
OBJECTIVES: Liver transplant patients are at risk of osteopenia and fractures but limited information is available in long-term survivors after childhood transplantation. This study aimed to assess bone mineral density (BMD) of very long-term, >5 years, survivors after liver transplantation in childhood. METHODS: Patients aged <18 years at transplant, having survived >5 years after transplant were potentially eligible but only those with ongoing review in our state were included...
December 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
Sabine Bélard, Charlotte C Heuvelings, Ebrahim Banderker, Lindy Bateman, Tom Heller, Savvas Andronikou, Lesley Workman, Martin P Grobusch, Heather J Zar
BACKGROUND: Point-of-care ultrasound (POCUS) detects extra-pulmonary tuberculosis (EPTB) in HIV-infected adults but has not been evaluated in children despite their higher risk of EPTB. This study's aims were to investigate feasibility of POCUS for EPTB in children, frequency of POCUS findings suggestive of EPTB, and time to sonographic resolution of findings with treatment. METHODS: This prospective South African cohort study enrolled children with suspected PTB...
December 22, 2017: Pediatric Infectious Disease Journal
Eric Wobudeya, Moorine Sekadde-Kasirye, Derrick Kimuli, Frank Mugabe, Deus Lukoye
BACKGROUND: The road map for childhood tuberculosis launched in 2013 provided strong renewed efforts focused towards zero deaths due to tuberculosis in children. From 2010, there were efforts to improve childhood tuberculosis diagnosis in Kampala and this study aimed to document the trend and outcome of tuberculosis in children over the period. METHODS: This was a retrospective study of tuberculosis data for Kampala city for the period 2011-2015. We extracted data from the unit TB registers in the 52 Diagnostic and treatment units (DTUs) in the Kampala...
December 19, 2017: BMC Public Health
Kefyalew Addis Alene, Kerri Viney, Emma S McBryde, Archie C A Clements
The burden of tuberculosis (TB) in children reflects continuing and recent transmission within a population. This study aimed to identify spatiotemporal and socio-climatic factors associated with paediatric TB in north-western Ethiopia. Multivariate Poisson regression models were computed using a Bayesian framework. Estimates of parameters were generated using Markov chain Monte Carlo simulation. A total of 2,240 children aged under 15 years diagnosed with TB during the years 2013- 2016 were included in the analysis...
November 27, 2017: Geospatial Health
Prachi Nangpal, Ritika Kar Bahal, Anil K Tyagi
Tuberculosis (TB) is one of the major causes of mortality all over the globe. BCG, the only vaccine available against this disease has been successful in preventing the severe forms of childhood TB. However, the unsatisfactory performance of BCG in controlling the adult pulmonary tuberculosis has made the development of an effective vaccine against M. tuberculosis a prime objective of the TB research. In this study, a genetically stable, marker-free recombinant MVA expressing α-crystallin of M. tuberculosis (rMVA...
December 11, 2017: Scientific Reports
Villa Watch, Jimmy Aipit, Tina Kote-Yarong, Allanie Rero, John W Bolnga, Elvin Lufele, Moses Laman
Background: In Papua New Guinea, TB is considered to be a major public health problem, but little is known about the prevalence and prognosis of presumed TB in children. Methods: As part of a prospective hospital-based surveillance on the northern coast of mainland Papua New Guinea, the authors investigated the admission prevalence and case fatality rate associated with presumed TB over a 6-year period (2011-2016). All children admitted who were diagnosed with TB were followed-up until discharge or death...
November 1, 2017: International Health
B Aw, S Ade, S G Hinderaker, N Dlamini, K C Takarinda, K Chiaa, A Feil, A Traoré, T Reid
Setting: The National Tuberculosis Programme, Mauritania. Objective: To compare the diagnosis and treatment outcomes of childhood tuberculosis (TB) cases (aged <15 years) registered between 2010 and 2015 inside and outside Nouakchott, the capital city. Design: This was a retrospective comparative cohort study. Results: A total of 948 children with TB were registered. The registration rate was 10 times higher in Nouakchott. The proportion of children among all TB cases was higher inside than outside Nouakchott (7...
September 21, 2017: Public Health Action
Samantha Fry, Shaun Barnabas, Mark F Cotton
PURPOSE OF REVIEW: Although tuberculosis (TB) causes much morbidity and mortality in children, diagnosis and treatment remain challenging. Recently, children have gained increasing attention in research and clinical trials driving improved contact management, case identification and treatment of both drug-susceptible and drug-resistant TB. This review highlights some recent advances. RECENT FINDINGS: The tuberculin skin test is the most widely used test to distinguish Mycobacterium tuberculosis (M...
February 2018: Current Opinion in Pediatrics
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