Related Experiment Videos
[Childhood tuberculosis and its diagnosis in Argentina]
Isabel N P Miceli1, María Delfina Sequeira, Isabel N de Kantor
1Sector Epidemiología, Area Programática, Hospital Prof. Dr. A. Posadas, Haedo, Argentina.
Insights
Tuberculosis (TB) in children under five shows a high notification rate in Argentina, indicating active transmission. Early diagnosis and contact investigation are crucial for effective childhood TB control.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Context:
- Tuberculosis (TB) poses a significant global health challenge, particularly in pediatric populations.
- In Argentina, the TB notification rate in children aged 0-4 years was 24.3/100,000 in 2000, with 17% of all TB cases occurring in children (0-14 years), signifying high transmission rates.
- Diagnosis is often delayed until advanced stages, relying on contact history, PPD tests, and clinical/radiological signs, with limited bacteriological confirmation.
Purpose:
- To highlight the epidemiological situation of childhood tuberculosis in Argentina.
- To discuss diagnostic challenges and limitations in pediatric TB.
- To emphasize the importance of laboratory network strengthening and early diagnostic interventions.
Summary:
- The TB notification rate in Argentinian children (0-4 years) was 24.3/100,000 in 2000, with children comprising 17% of all cases, indicating substantial TB transmission.
- Current diagnostic methods for childhood TB often lead to delayed diagnosis. Bacteriology, including gastric aspirates, PPD tests, and nucleic acid amplification assays, plays a role but requires improved quality control.
- Strengthening the laboratory network is essential for increasing diagnostic certainty, improving case reporting reliability, and understanding drug resistance profiles in childhood TB.
Impact:
- Enhanced laboratory networks can improve diagnostic accuracy and surveillance of childhood TB.
- Early diagnosis through contact tracing and prompt treatment can help reverse unfavorable TB epidemiological trends in children.
- The decline in TB meningitis among young children suggests BCG vaccination's protective effect, underscoring the importance of high vaccination coverage.
Abstract:
TB notification rate in infants and children 0-4 years was 24.3/100,000 in Argentina, in 2000, for a global incidence of 31.8/100,000. A 17% of all TB cases occurred in children (0-14 years), indicating a very active TB transmission. Usually TB is diagnosed when the disease is already advanced. Main criteria for the diagnosis are: a previous contact with an infectious TB patient, a positive PPD test result and clinical--radiological signs and symptoms. Bacteriology plays a limited role in diagnosis; gastric aspirate is the most often used specimen for bacteriological examination in children. Culture is performed on solid egg-media, but other more recently developed culture media systems are available in reference laboratories. Nucleic acid amplification assays are also used, but its systematic quality control is still lacking. Their results should be considered only as complementary. Strengthening of the laboratory network will contribute to increase diagnostic certainty of childhood TB, to improve reliability of cases reported, and to a better knowledge of the drug resistance profile. Early diagnosis of TB in children, by contacts investigation of infectious patients, followed by preventive chemotherapy or treatment when necessary, may revert the current epidemiological situation. TB meningitis in the 0-4 years group showed a significantly more pronounced decline than that of adults TB for the period 1980-2000, (only 10 meningitis cases were diagnosed in year 2000, 0.29/100,000), confirming the protection conferred by BCG vaccination when applied to newborns with a continuously high coverage.