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Tuberculosis in childrens

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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/29141915/laboratory-screening-for-children-entering-foster-care
#2
Mary V Greiner, Sarah J Beal, Katie Nause, Mary Allen Staat, Judith W Dexheimer, Philip V Scribano
OBJECTIVES: To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. METHODS: All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. RESULTS: Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic...
November 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/29140996/childhood-tuberculosis-is-associated-with-decreased-abundance-of-t-cell-gene-transcripts-and-impaired-t-cell-function
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/29126342/-tuberculosis-among-refugees-and-asylum-seekers-tuberculosis-screening-on-arrival-and-case-management
#11
Martin Priwitzer
The statement of the Federal Association of Physicians of Public Health Services provides recommendations concerning tuberculosis screening of refugees and asylum seekers on arrival specific to different groups of persons (adults, children, pregnant women, unaccompanied minors), taking into account the legal background and the current recommendations of the Robert Koch Institute as well as of the German Society for Pediatric Infectiology. In addition, recommendations are given to ensure treatment success in refugees and asylum seekers with tuberculosis, to carry out contact investigations and for preventive treatment of latent tuberculosis infection among refugees and asylum seekers...
November 10, 2017: Das Gesundheitswesen
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
#12
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/29122384/strengthening-global-vaccine-access-for-adolescents-and-adults
#13
REVIEW
Angeline Nanni, Stefanie Meredith, Stephanie Gati, Karin Holm, Tom Harmon, Ann Ginsberg
Global immunization efforts to date have heavily focused on infants and children, with noted success on public health. Healthy adolescents and adults contribute to the economic growth and development of countries but efforts to ensure vaccine coverage for these groups receive inadequate global attention and resources. Emerging epidemics for a number of infectious diseases including Ebola, Zika, dengue, malaria and the continuing epidemics of tuberculosis and several sexually transmitted infections, including HIV, HPV and Hepatitis B, have high incidence and prevalence in adolescents and adults...
November 6, 2017: Vaccine
https://www.readbyqxmd.com/read/29121953/risk-of-tuberculosis-among-alabama-children-and-adolescents-treated-with-tumor-necrosis-factor-inhibitors-a-retrospective-study
#14
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/29119087/a-new-primary-health-care-system-in-the-syrian-opposition-territories-good-effort-but-far-from-being-perfect
#15
Tarek Alsaied, Abdullah Mawas, Fatima Al Sayah, Abdulrazzak Kental, Maher Saqqur
Objectives: The primary health-care system in Syria has suffered a great deal of damage over the past 6 years. A large number of physicians and health-care providers have left the country. The objectives of this study are to describe our experience in establishing a primary health-care system in the opposition territories (OTs) in Syria and report the most common treated diseases. Methods: The administrative databases of ten primary care centers in the OT from January 2014 to December 2015 were reviewed...
October 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/29117827/tuberculosis-of-the-elbow-region-in-pediatric-age-group-experiences-from-a-single-centre
#16
Anil Agarwal, Anuj Rastogi
BACKGROUND: Clinical series of tuberculosis of elbow region in children are few. The purpose of our study was to retrospectively review the presentation, healing response and functional results of 30 children. METHODS: The pretreatment disease presentation was studied from patient's case records. Serial radiographs of the patients were studied to see remineralization and healing of radiological lesions. For elbow's functional evaluation, pain, range of motion and recurrence were observed at final follow up...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29116637/epidemiology-of-drug-resistant-tuberculosis
#17
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/29112745/drivers-of-tuberculosis-transmission
#18
REVIEW
Barun Mathema, Jason R Andrews, Ted Cohen, Martien W Borgdorff, Marcel Behr, Judith R Glynn, Roxana Rustomjee, Benjamin J Silk, Robin Wood
Measuring tuberculosis transmission is exceedingly difficult, given the remarkable variability in the timing of clinical disease after Mycobacterium tuberculosis infection; incident disease can result from either a recent (ie, weeks to months) or a remote (ie, several years to decades) infection event. Although we cannot identify with certainty the timing and location of tuberculosis transmission for individuals, approaches for estimating the individual probability of recent transmission and for estimating the fraction of tuberculosis cases due to recent transmission in populations have been developed...
November 3, 2017: Journal of Infectious Diseases
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
#19
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
#20
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
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