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Epidemiological aspects of tuberculosis in children and adolescents in Rio de Janeiro
Thaise Pereira Matos1, Afrânio Lineu Kritski, Antônio Ruffino Netto
1Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. thaise.silva@ig.com.br
Insights
This study analyzed childhood tuberculosis (TB) in Brazil, finding high rates of drug-resistant TB and HIV co-infection. Further research is needed to assess TB control effectiveness in children.
Area of Science:
- Epidemiology
- Infectious Diseases
- Pediatrics
Background:
- Childhood tuberculosis (TB) remains a significant global health challenge.
- Understanding the epidemiological characteristics of pediatric TB is crucial for effective control strategies.
- Brazilian reference hospitals serve as key centers for managing complex pediatric TB cases.
Purpose of the Study:
- To delineate the epidemiological profile of childhood tuberculosis (TB) in a Brazilian reference hospital.
- To identify key risk factors and clinical presentations associated with pediatric TB.
- To assess the prevalence of drug resistance and HIV co-infection in children with TB.
Main Methods:
- Retrospective study conducted between 1999 and 2008.
- Inclusion of 473 children (0-14 years) diagnosed with or treated for TB.
- Data collection through medical records, monitoring reports, and TB unit notifications.
Main Results:
- Tuberculin skin test positivity in 52% and history of contact with pulmonary TB in 66% of cases.
- Disseminated TB observed in 22% of children; HIV co-infection identified in 17% of tested cases.
- Confirmed TB diagnosis in 31%, more frequent in older children; 33% of tested isolates showed resistance to anti-TB drugs, with 0.8% multi-drug-resistant.
Conclusions:
- High rates of drug-resistant TB and HIV co-infection necessitate further investigation.
- Findings underscore the need to evaluate the impact of current TB control activities on pediatric populations.
- Urgent need for enhanced strategies to combat childhood TB, particularly drug-resistant forms and in co-infected individuals.
Objective:
To describe the epidemiological aspects of childhood tuberculosis (TB) in a Brazilian reference hospital.
Methods:
This was a retrospective study (1999-2008) of 473 subjects (0-14 year olds) with confirmed TB, or with clinical improvement by the fourth month of treatment under the unit's care, including the review of medical records, monitoring reports and notifications by the TB unit.
Results:
Among 473 TB cases included in the study, positive tuberculin skin test was observed in 52%, history of contact with a patient with pulmonary tuberculosis in 66%, mostly intra-household, and with the father/stepfather most commonly involved; and disseminated TB in 22%. The result of HIV testing was obtained in 265 (56%) cases, being positive in 45 (17%). The diagnosis of TB was confirmed in 31% of cases, most frequently in children older than 5 years, with negative tuberculin skin test, and in disseminated forms. Of the 65 cultures positive for TB performed in the study, drug sensitivity testing to anti-TB drugs was done in 30 (46%) clinical samples, among which 10 (33%) were resistant to one or more anti-TB drugs, and 2 (0.8%) were multi-drug-resistant. Among patients with confirmed pulmonary TB, 31% did not meet the criteria for starting anti-TB treatment according to the scores of the Ministry of Health (≤ 25 points).
Conclusion:
The high proportion of drug-resistant TB and co-infection with HIV identified in this study highlight the necessity to carry out additional studies in order to evaluate the impact of TB control activities on childhood TB.
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