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Risk Factors for Central Nervous System Tuberculosis

Alexandra Duque-Silva1, Katherine Robsky2, Jennifer Flood2

  • 1UCSF Benioff Children's Hospital Oakland, Oakland, California; and Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California.

Pediatrics
|October 7, 2015
PubMed

Insights

Pediatric central nervous system tuberculosis (CNS TB) disproportionately affects young children, US-born individuals, and Hispanic children in California. Targeted prevention efforts are crucial for these high-risk groups.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Tuberculosis (TB) remains a significant global health concern, with central nervous system (CNS) involvement representing a severe manifestation.
  • Pediatric TB, particularly CNS TB, presents unique diagnostic and therapeutic challenges.
  • Understanding the specific risk factors and epidemiological trends in pediatric CNS TB is essential for effective public health interventions.

Purpose of the Study:

  • To delineate the epidemiology of pediatric central nervous system tuberculosis (CNS TB) in California.
  • To identify demographic and clinical factors associated with the development of CNS TB in children.
  • To analyze factors contributing to mortality among pediatric CNS TB cases.

Main Methods:

  • Analysis of the California TB registry data for individuals aged 18 years and younger between 1993 and 2011.
  • Comparison of epidemiological and clinical characteristics between pediatric CNS TB cases and non-CNS TB cases.
  • Multivariate logistic regression models were employed to identify factors associated with CNS TB and TB-related deaths.

Main Results:

  • A total of 200 pediatric CNS TB cases were reported during the study period.
  • Children under 5 years old, US-born children, and Hispanic children demonstrated a significantly higher likelihood of developing CNS TB.
  • Negative tuberculin skin test results were observed in a notable proportion of CNS TB cases, and CNS TB and positive cultures were associated with increased mortality risk.

Conclusions:

  • Specific pediatric subpopulations in California are at an elevated risk for developing CNS TB.
  • These identified high-risk groups may benefit from targeted prevention strategies and enhanced surveillance.
  • Further research into the specific vulnerabilities and optimal interventions for pediatric CNS TB is warranted.
Abstract

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