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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Active surveillance for tuberculosis in Wales: 1996-2003
B Fathoala1, M R Evans, I A Campbell
1Department of Child Health, Cardiff and Vale NHS Trust, Cardiff, UK. basam@btinternet.com
Insights
Tuberculosis (TB) incidence in children in Wales is low, but the disease is increasingly affecting Black African children and presenting as disseminated TB. Many eligible children are not receiving BCG immunisation, highlighting prevention gaps.
Area of Science:
- Pediatric infectious diseases
- Public health surveillance
- Epidemiology of tuberculosis
Background:
- Tuberculosis (TB) remains a global health concern, requiring ongoing surveillance and management strategies, particularly in pediatric populations.
- Understanding the epidemiology of childhood TB is crucial for effective prevention and control programs.
Purpose of the Study:
- To estimate the incidence of active and latent tuberculosis (TB) in children in Wales.
- To analyze the use of chemoprophylaxis for latent TB in children.
- To identify areas for improvement in TB prevention and management among children.
Main Methods:
- Active surveillance of children aged 0-15 years for TB from July 1996 to December 2003.
- Utilized the Welsh Paediatric Surveillance Scheme for data collection.
Main Results:
- Identified 232 children with TB: 102 active (2.3/100,000) and 130 latent (2.9/100,000).
- Nearly half of affected children belonged to ethnic minorities, with 19% of Black African origin.
- Pulmonary disease was most common (47%); disseminated TB occurred in 10 children, primarily under 10.
- BCG immunisation coverage was 59% among eligible children; household contacts were the main source of infection, with school outbreaks noted.
Conclusions:
- Childhood TB incidence in Wales is low but shows evolving epidemiology, with a rising proportion in Black African children.
- A significant number of disseminated TB cases is a concern.
- TB in teenagers is linked to school outbreaks, and low BCG immunisation rates indicate room for enhanced prevention efforts.
Aims:
To estimate the incidence of active tuberculosis (TB) and study the use of chemoprophylaxis for latent TB in children in Wales, and to identify potential areas for improving prevention and management.
Methods:
Active surveillance for TB in children aged 0-15 years from July 1996 to December 2003, using the Welsh Paediatric Surveillance Scheme.
Results:
A total of 232 children, 102 with active TB (2.3 per 100 000) and 130 with latent TB (2.9 per 100 000), were identified. Nearly half (45%) belonged to ethnic minorities (19% were of black African origin), a much higher proportion than the base population. Pulmonary disease was the most common presentation (47%), including six (9%) children who were sputum smear positive. There were 10 cases of disseminated TB, nearly all in white children under 10 years of age. Less than two thirds of eligible children (27/46, 59%) were known to have received BCG immunisation. The source of infection was an adult household contact in most cases, but was not known in 44 cases, particularly among teenagers. Four community outbreaks occurred during the surveillance period, including three in high schools.
Conclusion:
TB incidence in children in Wales remains low, but the epidemiology is changing with an increasing proportion of cases in black African children. The high proportion of patients with disseminated TB is of particular concern. TB in teenagers was often associated with school outbreaks. Many eligible children do not receive BCG immunisation, indicating further scope for prevention.
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