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Published on: August 11, 2008
Pediatric Tuberculosis in Northern Sardinia
Maria Grazia Clemente1, Elena Dore1, Lidia Abis1
1Pediatric Clinic, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
Insights
Immigration is a risk factor for pediatric tuberculosis (TB) in Northern Sardinia, with immigrants showing higher TB infection rates. Early detection and treatment are crucial for managing pediatric TB and preventing its spread.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Epidemiology
Background:
- Migration flux presents public health challenges, particularly concerning pediatric infectious diseases.
- Tuberculosis (TB) is a significant concern in pediatric populations, especially in areas with increasing immigration.
- Investigating immigration as a risk factor for pediatric TB is crucial for public health strategies.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of pediatric tuberculosis (TB) in Northern Sardinia.
- To assess the role of immigration as a risk factor for pediatric TB.
- To understand the epidemiology of TB in a high-risk pediatric population.
Main Methods:
- An observational retrospective study was conducted over a 6-year period (2009-2014).
- Data were collected from children referred to the Pediatric Infectious Diseases Unit in Northern Sardinia.
- Diagnostic methods included TB skin test (TST), QuantiFERON Gold, thorax X-ray, microbiological cultures, and molecular assays.
Main Results:
- Out of 246 children, 24 were immigrants, and 205 showed no TB infection.
- TST positivity was significantly higher in immigrant children (42.5%) compared to native Sardinian children (14%).
- Active TB was diagnosed in 20 children, with pulmonary involvement being the most common presentation.
Conclusions:
- Pediatric TB is a relevant and potentially increasing public health issue in Northern Sardinia.
- Immigration is identified as a significant risk factor for pediatric TB.
- Strict surveillance and prompt treatment are essential to mitigate severe TB forms and transmission.
Background And Objectives:
Migration flux is an increasing phenomenon in Italy, and it raises several public health issues and concerns in pediatric infectious diseases. This study investigated the clinical characteristics and outcomes of a pediatric population at high-risk for tuberculosis (TB) and the potential role of immigration as a risk factor.
Design:
We performed an observational retrospective study of children referred to the only Pediatric Infectious Diseases Unit for Northern Sardinia over a 6-year-period (2009-2014). Main variables assessed included TB skin test (TST), confirmed by quantiFERON Gold in Tube test, thorax X-ray (TX), microbiological culture, direct microscopy for acid-fast bacilli and molecular assays.
Results:
Of the 246 children (mean age = 5.8 ± 3.9 years) identified, 222 (90.2%) were native to Sardinia and 24 (9.8%) were immigrants. The majority of children (n=205; 83%) were TB-exposed but not infected based on a negative TST and TX. Among the TST positive group (n= 39; 16%), 19 (49%) had latent TB (TX negative), while 20 (51%) had active TB (TX positive). The percent of TST positive children was significantly higher in the immigrant than the native group (42.5% versus 14%, p<0.001). Clinical presentations included pulmonary involvement with hilar lymphadenopathy (72%), pleurisy (13,5%), lateral-cervical lymphadenopathy (9%), pneumonia with calcifications (4.5%) and disseminated TB (4.5%). One child had multidrug-resistant tuberculosis.
Conclusions:
Pediatric TB represents a relevant and potentially worsening public health problem in Northern Sardinia. A strict surveillance system and appropriate treatment can prevent the most severe forms and reduce TB transmission.
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