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Screening and follow-up of children exposed to tuberculosis cases, Luanda, Angola

I Fortunato1, C Sant'Anna

  • 1Department of Infectious Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|January 31, 2012
PubMed

Insights

In Angola, young children exposed to tuberculosis (TB) faced high risks. Despite screening, many with latent TB infection progressed to active disease within six months.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Tuberculosis (TB) remains a significant global health threat, particularly in high-burden countries like Angola.
  • Children under 5 years with reported contact with adult TB patients are at increased risk of infection and disease.
  • Co-infection with human immunodeficiency virus (HIV) can complicate TB management and outcomes in children.

Purpose of the Study:

  • To assess the incidence of active TB disease in young children with a history of contact with adult TB patients.
  • To evaluate the progression of latent TB infection (LTBI) to active TB in this vulnerable pediatric population.
  • To determine the effectiveness of a combined diagnostic strategy (chest X-ray and TB skin test) in identifying children at risk.

Main Methods:

  • A prospective study was conducted in Angola involving 124 children under 5 years old with known contact to adult TB patients.
  • Participants were categorized into active TB cases, latent TB infection (LTBI), and TB-exposed groups.
  • A diagnostic strategy involving simultaneous chest X-ray and TB skin testing was employed, followed by a 6-month observation period.

Main Results:

  • Out of 124 children, 70 had active TB, 22 had LTBI, and 32 were TB-exposed. 14% were HIV-positive.
  • A significant proportion of children with LTBI (31.8%) progressed to active TB within 6 months.
  • Even with the implemented screening protocol, 9.4% of initially non-infected children also developed active TB.

Conclusions:

  • The diagnostic strategy of simultaneous chest X-ray and TB skin test showed some effectiveness but did not fully prevent progression to active TB in children with LTBI.
  • Young children exposed to adult TB patients, particularly those with LTBI, remain at high risk of developing active disease.
  • Further research and improved interventions are needed to enhance TB prevention and control in high-risk pediatric populations in resource-limited settings.

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