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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis

Published on: August 11, 2008

Tuberculosis in children exposed at home to multidrug-resistant tuberculosis

Mercedes C Becerra1, Molly F Franke, Sasha C Appleton

  • 1Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. mbecerra@post.harvard.edu

The Pediatric Infectious Disease Journal
|August 29, 2012
PubMed

Insights

Children exposed to multidrug-resistant tuberculosis (MDR-TB) face a high risk of developing TB disease, especially in the first year after diagnosis of an infectious household member. This underscores the urgent need for pediatric contact investigations and prompt treatment.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pediatrics

Background:

  • The global burden of tuberculosis (TB) in children exposed to multidrug-resistant tuberculosis (MDR-TB) within households remains largely unquantified.
  • Millions of children worldwide are chronically exposed to infectious MDR-TB patients due to limited treatment access.

Purpose of the Study:

  • To quantify the burden of TB disease among child household contacts of MDR-TB patients.
  • To estimate the prevalence and incidence of TB disease in children exposed to MDR-TB.

Main Methods:

  • A retrospective cohort study was conducted in Lima, Peru, from 1996 to 2003.
  • Included child and adult household contacts of patients treated for MDR-TB.
  • Primary outcome was TB disease, with prevalence estimated at index case treatment start and incidence tracked over 4 years.

Main Results:

  • Among 1299 child contacts, TB prevalence was 1771 per 100,000 children.
  • TB incidence was highest in the first year (2079 per 100,000 child-years), remaining elevated over 4 years.
  • Child contacts exhibited TB disease rates approximately 30 times higher than the general pediatric population, with 20% of TB cases occurring in children.

Conclusions:

  • Children exposed to MDR-TB patients face a significant risk of TB disease at the time of diagnosis and in the subsequent year.
  • Highlights the critical need for contact investigations and timely referral/treatment systems for pediatric household contacts of MDR-TB patients.
  • Recommendations apply regardless of the child's age, emphasizing universal screening and care.
Abstract

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