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latent tuberculosis in children

Madhukar Pai, Mark P Nicol, Catharina C Boehme
Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement...
October 2016: Microbiology Spectrum
Roberta Petrucci, Giulia Lombardi, Ilaria Corsini, Maria Letizia Bacchi Reggiani, Francesca Visciotti, Filippo Bernardi, Maria Paola Landini, Salvatore Cazzato, Paola Dal Monte
BACKGROUND: The diagnostic accuracy of Quantiferon-TB Gold In-Tube (QFT-IT) is uncertain in the pediatric population, while tuberculin skin test (TST) is still conventionally used despite its limitations. The aim of this study was to compare the performance of QFT-IT with TST in a large cohort of children screened for TB infection because of contact tracing, suspected TB, arrival from endemic country or immunosuppressive therapy. METHODS: A retrospective analysis was conducted on 517 children 0-14 years of age evaluated at the pediatric unit of the S...
October 3, 2016: Pediatric Infectious Disease Journal
Samuel G Schumacher, Maarten van Smeden, Nandini Dendukuri, Lawrence Joseph, Mark P Nicol, Madhukar Pai, Heather J Zar
Evaluation of tests for the diagnosis of childhood pulmonary tuberculosis (CPTB) is complicated by the absence of an accurate reference test. We present a Bayesian latent class analysis in which we evaluated the accuracy of 5 diagnostic tests for CPTB. We used data from a study of 749 hospitalized South African children suspected to have CPTB from 2009 to 2014. The following tests were used: mycobacterial culture, smear microscopy, Xpert MTB/RIF (Cepheid Inc.), tuberculin skin test (TST), and chest radiography...
October 13, 2016: American Journal of Epidemiology
Wilson Kwong, Thomas Krahn, Ann Cleland, Janet Gordon, Wendy Wobeser
BACKGROUND: Current Canadian guidelines suggest that neonatal Bacille Calmette-Guérin (BCG) vaccination does not result in false-positive tuberculosis (TB) skin tests, despite a growing body of evidence that interferon-γ release assays may be a more specific alternative in identifying latent tuberculosis infections in vaccinated populations. We set out to evaluate the relationship between TB skin tests and interferon-γ release assays in patients who previously received neonatal BCG vaccine...
July 2016: CMAJ Open
Margret Johansson Gudjónsdóttir, Karsten Kötz, Ruth Stangebye Nielsen, Philip Wilmar, Sofia Olausson, Daniel Wallmyr, Birger Trollfors
BACKGROUND: Immigrants from countries with high incidence of tuberculosis (TB) are usually offered screening when they arrive to low incidence countries. The tuberculin skin test (TST) is often used. The interferon gamma release assays (IGRAs) are more specific and not affected by BCG vaccination. The aims of this study were 1. To see if there if there is a correlation between a positive IGRA (QFT) and presence of a BCG scar in children with TST ≥10 mm, 2. To compare the TST diameter with QFT result, 3...
October 6, 2016: BMC Infectious Diseases
Ki Wook Yun, Young Kwang Kim, Hae Ryun Kim, Mi Kyung Lee, In Seok Lim
PURPOSE: Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-γ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI. METHODS: We performed a tuberculin skin test (TST) and IGRA on children who were younger than 18 years and were admitted to Chung-Ang University Hospital during May 2011-June 2015...
June 2016: Korean Journal of Pediatrics
Luisa Galli, Laura Lancella, Chiara Tersigni, Elisabetta Venturini, Elena Chiappini, Barbara Maria Bergamini, Margherita Codifava, Cristina Venturelli, Giulia Tosetti, Caterina Marabotto, Laura Cursi, Elena Boccuzzi, Silvia Garazzino, Pier Angelo Tovo, Michele Pinon, Daniele Le Serre, Laura Castiglioni, Andrea Lo Vecchio, Alfredo Guarino, Eugenia Bruzzese, Giuseppe Losurdo, Elio Castagnola, Grazia Bossi, Gian Luigi Marseglia, Susanna Esposito, Samantha Bosis, Rita Grandolfo, Valentina Fiorito, Piero Valentini, Danilo Buonsenso, Raffaele Domenici, Marco Montesanti, Filippo Maria Salvini, Enrica Riva, Icilio Dodi, Francesca Maschio, Luisa Abbagnato, Elisa Fiumana, Chiara Fornabaio, Patrizia Ballista, Vincenzo Portelli, Gabriella Bottone, Nicola Palladino, Mariella Valenzise, Barbara Vecchi, Maria Di Gangi, Carla Lupi, Alberto Villani, Maurizio de Martino
Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled...
2016: International Journal of Molecular Sciences
Peter Auguste, Alexander Tsertsvadze, Joshua Pink, Rachel Court, Farah Seedat, Tara Gurung, Karoline Freeman, Sian Taylor-Phillips, Clare Walker, Jason Madan, Ngianga-Bakwin Kandala, Aileen Clarke, Paul Sutcliffe
BACKGROUND: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB) [(Zopf 1883) Lehmann and Neumann 1896], is a major cause of morbidity and mortality. Nearly one-third of the world's population is infected with MTB; TB has an annual incidence of 9 million new cases and each year causes 2 million deaths worldwide. OBJECTIVES: To investigate the clinical effectiveness and cost-effectiveness of screening tests [interferon-gamma release assays (IGRAs) and tuberculin skin tests (TSTs)] in latent tuberculosis infection (LTBI) diagnosis to support National Institute for Health and Care Excellence (NICE) guideline development for three population groups: children, immunocompromised people and those who have recently arrived in the UK from high-incidence countries...
May 2016: Health Technology Assessment: HTA
Jennifer A Grinsdale, Shamim Islam, Olivia Chang Tran, Christine S Ho, L Masae Kawamura, Julie M Higashi
BACKGROUND: Interferon-gamma release assay utilization in pediatric tuberculosis (TB) screening is limited by a paucity of longitudinal experience, particularly in low-TB burden populations. METHODS: We conducted a retrospective review of QuantiFERON (QFT)-TB Gold results in San Francisco children from 2005 to 2008. Concordance with the tuberculin skin test (TST) was analyzed for a subset of children. Progression to active disease was determined through San Francisco and California TB registry matches...
June 2016: Journal of the Pediatric Infectious Diseases Society
Angela Marcia Cabral Mendonça, Afrânio Lineu Kritski, Marcelo Gerardin Poirot Land, Clemax Couto Sant'Anna
BACKGROUND: Routine data on the use of isoniazid preventive therapy (IPT) in children and adolescents are scarce in high tuberculosis (TB) burden countries. OBJECTIVE: To describe the factors related to abandonment of IPT in children and adolescents with latent tuberculosis infection (LTBI) receiving routine care. METHODS: Retrospective (2005-2009) descriptive study of 286 LTBI cases with indication of IPT and serviced at a pediatric hospital in the State of Rio de Janeiro, Brazil...
2016: PloS One
A Berraies, B Hamdi, J Ammar, H Snen, W Bouhaouel, A Hamzaoui
INTRODUCTION: Tuberculosis screening in children is important to identify and treat latent tuberculosis infection and thus avoid progression to disease. METHODS: It is a prospective study realized in 83 children between November 2009 and January 2013 who consulted after a household contact for tuberculosis in the pediatric department B of Abderrahmen Mami hospital of Ariana. RESULTS: The mean age of the children was 4.8 years (3 months-15 years)...
May 2016: Revue de Pneumologie Clinique
James J Dunn, Jeffrey R Starke, Paula A Revell
Diagnosis of tuberculosis in children is challenging; even with advanced technologies, the diagnosis is often difficult to confirm microbiologically in part due to the paucibacillary nature of the disease. Clinical diagnosis lacks standardization, and traditional and molecular microbiologic methods lack sensitivity, particularly in children. Immunodiagnostic tests may improve sensitivity, but these tests cannot distinguish tuberculosis disease from latent infection and some lack specificity. While molecular tools like Xpert MTB/RIF have advanced our ability to detect Mycobacterium tuberculosis and to determine antimicrobial resistance, decades old technologies remain the standard in most locales...
June 2016: Journal of Clinical Microbiology
Nello Blaser, Cindy Zahnd, Sabine Hermans, Luisa Salazar-Vizcaya, Janne Estill, Carl Morrow, Matthias Egger, Olivia Keiser, Robin Wood
BACKGROUND: Tuberculosis (TB) is the leading cause of death in South Africa. The burden of disease varies by age, with peaks in TB notification rates in the HIV-negative population at ages 0-5, 20-24, and 45-49 years. There is little variation between age groups in the rates in the HIV-positive population. The drivers of this age pattern remain unknown. METHODS: We developed an age-structured simulation model of Mycobacterium tuberculosis (Mtb) transmission in Cape Town, South Africa...
March 2016: Epidemics
A P Barbosa Silva, P Hill, M T C T Belo, S G Rabelo, D Menzies, A Trajman
BACKGROUND: Children with latent tuberculous infection (LTBI) are particularly vulnerable to progression to active tuberculosis (TB), and are thus a priority target for isoniazid preventive therapy (IPT). However, adherence to IPT is poor. We hypothesised that children from poorer families, with reduced access to health care and lack of understanding about the disease are more likely to default from IPT. METHODS: A questionnaire was administered to close child contacts or their parents at the time of prescribing IPT in three cities in Rio de Janeiro State...
April 2016: International Journal of Tuberculosis and Lung Disease
Bhanu Williams, Lucy Pickard, Louis Grandjean, Sue Pope, Sarah R Anderson, Gail Morgan, Amanda Williams
BACKGROUND: In January 2013 a secondary school pupil in London was diagnosed with sputum-smear positive pulmonary tuberculosis (TB) and was started on treatment. In April 2013 another pupil in the same year group at the same school was diagnosed with sputum-smear positive pulmonary TB. Pupils in the same year were then screened for tuberculosis. METHODS: Interferon gamma release assay (IGRA) testing was used to identify those infected with tuberculosis. Further tests were conducted to identify contacts with active tuberculosis disease and specimens were sent for genotypic testing...
March 3, 2016: Journal of Public Health
Connie G M Erkens, Erika Slump, Maurits Verhagen, Henrieke Schimmel, Gerard de Vries, Frank Cobelens, Susan van den Hof
Targeted diagnosis and treatment of latent tuberculosis (TB) infection (LTBI) among persons with a high risk of exposure to TB or of developing TB when infected has been performed and monitored routinely in the Netherlands since 1993. We describe trends in target groups, diagnostic methods and treatment regimens, and explore determinants for treatment initiation, treatment completion and adverse events.In total, 37 729 persons were registered with LTBI from 1993 to 2013, of whom 28 931 (77%) started preventive treatment; 82% of those completed preventive treatment and 8% stopped preventive treatment due to adverse events...
May 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Akshay Gupte, Chandrasekaran Padmapriyadarsini, Vidya Mave, Dileep Kadam, Nishi Suryavanshi, Shri Vijay Bala Yogendra Shivakumar, Rewa Kohli, Nikhil Gupte, Kannan Thiruvengadam, Anju Kagal, Sushant Meshram, Renu Bharadwaj, Sandhya Khadse, Geetha Ramachandran, Luke Elizabeth Hanna, Neeta Pradhan, N S Gomathy, Andrea DeLuca, Amita Gupta, Soumya Swaminathan
INTRODUCTION: Tuberculosis disease (TB) remains an important global health threat. An evidence-based response, tailored to local disease epidemiology in high-burden countries, is key to controlling the global TB epidemic. Reliable surrogate biomarkers that predict key active disease and latent TB infection outcomes are vital to advancing clinical research necessary to 'End TB'. Well executed longitudinal studies strengthening local research capacity for addressing TB research priorities and advancing biomarker discovery are urgently needed...
2016: BMJ Open
Timothy E Sweeney, Lindsay Braviak, Cristina M Tato, Purvesh Khatri
BACKGROUND: Active pulmonary tuberculosis is difficult to diagnose and treatment response is difficult to effectively monitor. A WHO consensus statement has called for new non-sputum diagnostics. The aim of this study was to use an integrated multicohort analysis of samples from publically available datasets to derive a diagnostic gene set in the peripheral blood of patients with active tuberculosis. METHODS: We searched two public gene expression microarray repositories and retained datasets that examined clinical cohorts of active pulmonary tuberculosis infection in whole blood...
March 2016: Lancet Respiratory Medicine
Sundari R Mase, John A Jereb, Daniel Gonzalez, Fatma Martin, Charles L Daley, Dorina Fred, Ann M Loeffler, Lakshmy R Menon, Sapna Bamrah Morris, Richard Brostrom, Terence Chorba, Charles A Peloquin
BACKGROUND: In the Federated States of Micronesia and then the Republic of the Marshall Islands (RMI), levofloxacin pharmacokinetics were studied in children receiving directly observed once-daily regimens (10 mg/kg, age >5 years; 15-20 mg/kg, age ≤5 years) for either multidrug-resistant tuberculosis disease or latent infection after multidrug-resistant tuberculosis exposure, to inform future dosing strategies. METHODS: Blood samples were collected at 0 (RMI only), 1, 2 and 6 hours (50 children, aged 6 months to 15 years) after oral levofloxacin at >6 weeks of treatment...
April 2016: Pediatric Infectious Disease Journal
Joan Calzada-Hernández, Jordi Anton-López, Rosa Bou-Torrent, Estíbaliz Iglesias-Jiménez, Sílvia Ricart-Campos, Javier Martín de Carpi, Vicenç Torrente-Segarra, Judith Sánchez-Manubens, Clara Giménez-Roca, Librada Rozas-Quesada, Maria Teresa Juncosa-Morros, Clàudia Fortuny, Antoni Noguera-Julian
BACKGROUND: Adult patients receiving anti-TNFα drugs are at increased risk of tuberculosis (TB), but studies in pediatric populations are limited, and the best strategy for latent tuberculosis infection (LTBI) screening in this population remains controversial. We describe the prevalence of LTBI prior to anti-TNFα therapy and the long-term follow-up after biological treatment initiation in a cohort of children and adolescents. METHODS: Cohort observational study in children and adolescents receiving anti-TNFα agents in a tertiary-care pediatric hospital...
2015: Pediatric Rheumatology Online Journal
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