Tuberculosis Burden among Household Pediatric Contacts of Adult Tuberculosis Patients
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Published on: October 8, 2018
Rajeshwar Dayal1, Dipti Agarwal2, Rakesh Bhatia1
1Department of Pediatrics, S. N. Medical College, Agra, India.
Insights
Latent tuberculosis (TB) infection is highly prevalent in children living with adults who have drug-resistant TB. Lower socioeconomic status, male gender, and lack of BCG immunization increase TB risk in these pediatric contacts.
Area of Science:
- Pediatric infectious diseases
- Public health
- Tuberculosis research
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly in household settings.
- Understanding transmission dynamics in pediatric contacts is crucial for effective TB control.
- Drug-resistant TB poses unique challenges in transmission and management.
Purpose of the Study:
- To determine the prevalence of latent TB infection (LTBI) and active TB disease in children exposed to adult TB patients.
- To identify risk factors associated with TB infection among pediatric household contacts.
- To compare TB infection rates between contacts of drug-susceptible (DS) and multidrug-resistant (MDR) TB patients.
Main Methods:
- A study involving 271 pediatric household contacts (under 15 years) of adult TB patients (MDR and DS).
- Classification of contacts into LTBI, TB disease, or TB exposed using tuberculin skin testing, clinical examination, and chest X-ray.
- Evaluation of factors like age, gender, socioeconomic status, and BCG immunization for association with TB transmission.
Main Results:
- Overall LTBI prevalence was 20.3%, with significantly higher rates in contacts of MDR TB patients (31%) compared to DS TB patients (14%).
- No active TB disease was observed in pediatric contacts of MDR TB patients, while 3 cases occurred in the DS TB group.
- Lower socioeconomic status was a significant risk factor for TB infection in the MDR TB contact group (p=0.0027).
- Male gender and BCG non-immunization were significantly associated with increased TB risk in the DS TB contact group (p=0.0068 and p=0.0167, respectively).
Conclusions:
- Latent TB infection is highly prevalent in pediatric household contacts, especially those exposed to MDR TB.
- Key risk factors for TB infection in children include lower socioeconomic status, male gender, and BCG non-immunization.
- The findings underscore the importance of systematic contact screening and its integration into TB control strategies.
Objectives:
To find out the prevalence of latent tuberculosis (TB) infection and TB disease among pediatric household contacts of adult drug resistant (MDR) and drug susceptible (DS) TB patients and to identify the risk factors for occurrence of TB infection in the contacts.
Methods:
Pediatric household contacts (less than 15 y age) of adult TB patients (both MDR and DS) were included in the study. They were categorized as latent TB infection (LTBI), TB disease and TB exposed based on the results of tuberculin skin testing (TST), clinical examination and chest X-ray. Various factors (age, gender, socioeconomic status, BCG immunization etc.) were evaluated to assess their association with TB transmission.
Results:
A total of 271 household contacts were included in the study. Prevalence of LTBI was 20.3% (31% in MDR TB group and 14% in DS TB group); difference was significant (p value = 0.0018). TB disease was seen in 3 subjects in DS group while none in MDR group developed TB disease. Lower socioeconomic status was significantly associated with risk of TB infection in MDR group (p value =0.0027). In DS TB group, male gender, BCG non-immunization was significantly associated with risk of developing TB (p value 0.0068 and 0.0167 respectively).
Conclusions:
Prevalence of latent TB infection was found to be high in household pediatric contacts especially in contacts of MDR TB patients. Risk factors identified for occurrence of TB included lower socioeconomic status, BCG non-immunization and male gender. The study focuses on the importance of contact screening and the need for its implementation in TB control programs.
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