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Immunologic-based diagnosis of latent tuberculosis among children less than 5 years of age exposed and unexposed to tuberculosis in Tanzania : implications for tuberculosis infection screening

Said, Khadija and Hella, Jerry and Ruzegea, Mwajabu and Solanki, Rajesh and Chiryamkubi, Magreth and Mhimbira, Francis and Ritz, Nicole and Schindler, Christian and Mandalakas, Anna M. and Manji, Karim and Tanner, Marcel and Utzinger, Jürg and Fenner, Lukas. (2018) Immunologic-based diagnosis of latent tuberculosis among children less than 5 years of age exposed and unexposed to tuberculosis in Tanzania : implications for tuberculosis infection screening. Pediatric infectious disease journal, 38 (4). pp. 333-339.

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Official URL: https://edoc.unibas.ch/69847/

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Abstract

Childhood tuberculosis (TB) is acquired following exposure to an infectious TB case, often within the household. We prospectively screened children 6-59 months of age, exposed and unexposed to an infectious TB case within the same household, for latent tuberculosis infection (LTBI), in Dar es Salaam, Tanzania.; We collected medical data and clinical specimens (to evaluate for helminths, TB and HIV coinfections) and performed physical examinations at enrollment and at 3-month and 6-months follow-up surveys. LTBI was assessed using QuantiFERON (QFT) at enrollment and at 3 months.; In total, 301 children had complete data records (186 with TB exposure and 115 without known TB exposure). The median age of children was 26 months (range 6-58); 52% were females, and 4 were HIV-positive. Eight children (3%) developed TB during the 6-month follow-up. We found equal proportions of children with LTBI among those with and without exposure: 20% (38/186) vs. 20% (23/115) QFT-positive, and 2% (4/186) vs. 4% (5/115) indeterminate QFT. QFT conversion rate was 7% (22 children) and reversion 8% (25 children). Of the TB-exposed children, 72% initiated isoniazid preventive therapy (IPT), but 61% of parents/caregivers of children with unknown TB exposure and positive QFT refused IPT.; In this high burden TB setting, TB exposure from sources other than the household was equally important as household exposure. Nearly one third of eligible children did not receive IPT. Evaluation for LTBI in children remains an important strategy for controlling TB, but should not be limited to children with documented TB exposure.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Malaria Vaccines (Tanner)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Vaccines (Tanner)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Health Impact Assessment (Utzinger)
UniBasel Contributors:Hella, Jerry and Schindler, Christian and Tanner, Marcel and Utzinger, Jürg
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Lippincott Williams & Wilkins
ISSN:0891-3668
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:20 Mar 2019 13:45
Deposited On:20 Mar 2019 13:45

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