Tuberculosis Transmission in Danish Children: A Nationwide Register-based Study
Anne Christine Nordholm1,2, Line Lindebo Holm3, Erik Svensson4
1From the Department of Infectious Diseases, Copenhagen University Hospital Rigshospitalet.
Insights
Ongoing tuberculosis (TB) transmission occurs in Danish children, primarily within households. Early diagnosis and contact tracing are crucial for managing childhood TB in low-incidence settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Tuberculosis (TB) is a significant global child health concern.
- Limited data exists on TB transmission dynamics in children residing in low-incidence countries.
Purpose of the Study:
- To investigate TB transmission patterns among children under 15 in Denmark.
- To understand the epidemiology of childhood TB in a low-incidence European setting.
Main Methods:
- Retrospective analysis of national TB surveillance data (2000-2013).
- Inclusion of demographic data and TB contact information from national registers.
- Utilized data from the International Reference Laboratory of Mycobacteriology.
Main Results:
- Identified 88 childhood TB cases, with a mean annual incidence of 6.9 per million.
- 83% of cases had a known TB contact, predominantly household members (60%).
- 35% of culture-verified TB cases belonged to a prevalent cluster among adult Danes, indicating ongoing transmission.
Conclusions:
- Confirmed ongoing tuberculosis transmission within Danish households, even in a low-incidence population.
- Highlighted the critical need for prompt TB diagnosis in children.
- Emphasized the importance of comprehensive contact tracing and identifying at-risk populations for TB prevention.
Background:
Tuberculosis (TB) remains a major public health issue among children worldwide. Data on TB transmission in children living in low-incidence countries is limited.
Methods:
We studied TB transmission in ethnic Danish children younger than 15 years of age between 2000 and 2013. Identification of children with TB disease and information on demographics and TB contacts were retrieved from the national TB surveillance register and the International Reference Laboratory of Mycobacteriology.
Results:
In total, 88 children with TB disease were identified in the study period, corresponding to a mean annual incidence of 6.9 per 1,000,000 children younger than 15 years of age. The male to female ratio was 1.3. Median age was 5 years (interquartile range, 3-8.5). Seventy-three (83%) children had a known TB contact of which 60% was among household contacts with recent TB, predominantly parents. Sixty-six (75%) children were classified as part of epidemiologic clusters. Thirty-five (40%) children had culture verified TB of which information on genotypes was available for 34 (97%). Of these, 35% belonged to cluster C2/1112-15, the most prevalent cluster among adult Danes.
Conclusions:
We found on-going TB transmission in Danish children within the households of a low TB incidence population. These findings emphasize the need for early diagnosis of TB in children, thorough contact tracing and increased focus on risk groups.
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