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Overview of paediatric tuberculosis cases treated in the Sydney Children's Hospitals Network, Australia
Laila S Al Yazidi1, Ben J Marais2, Meredith Wickens3
1Immunology and Infectious Diseases Department, Sydney Children's Hospital, NSW, Australia; School of Women's and Children's Health, UNSW Sydney, Australia; Infectious Diseases and Microbiology Department, The Children's Hospital at Westmead, Sydney, NSW, Australia, drlaila83@hotmail.com.
Insights
Paediatric tuberculosis (TB) is a concern in Sydney
Area of Science:
- Paediatric infectious diseases
- Public health surveillance
- Epidemiology of tuberculosis
Background:
- Sydney hosts a large, mobile immigrant population.
- Documented patterns of paediatric tuberculosis (TB) in this diverse urban setting are limited.
- Understanding TB epidemiology in children is crucial for public health initiatives.
Purpose of the Study:
- To investigate the epidemiology of paediatric tuberculosis (TB) in Sydney, Australia.
- To identify risk factors and clinical characteristics of TB in children within the Sydney Children's Hospitals Network (SCHN).
- To inform targeted prevention and surveillance strategies for childhood TB.
Main Methods:
- Retrospective review of paediatric TB cases notified in New South Wales (NSW) from 2014-2015.
- Inclusion of an expanded dataset for children managed at the Sydney Children's Hospitals Network (SCHN).
- Analysis of demographic, clinical, microbiological, and vaccination data.
Main Results:
- 26 children under 15 years were diagnosed with TB in NSW over two years.
- In the SCHN cohort, 91.3% of paediatric TB cases had recent immigration or travel history to high-incidence countries.
- Severe disease (miliary TB, tuberculous meningitis) was more common in unvaccinated children; all isolates were drug-susceptible.
Conclusions:
- Children with recent travel to high TB incidence areas are at significant risk.
- Enhanced TB prevention and surveillance are needed for at-risk children, especially those travelling internationally.
- Targeted public health interventions are essential to reduce the burden of paediatric TB.
Background:
Sydney has a large and highly mobile immigrant community. The pattern of paediatric tuberculosis (TB) disease in this highly cosmopolitan city is not well documented.
Methods:
We reviewed data on all children notified with TB in New South Wales (NSW), Australia, from January 2014 to December 2015, complemented by an expanded dataset for children managed within the Sydney Children's Hospitals Network (SCHN).
Results:
Over the 2-year study period, 921 TB cases were identified in NSW, including 26 (2.8%) children younger than 15 years of age. Of 23 children and adolescents treated for TB in the SCHN, 21 (91.3%) had a history of recent immigration from, or travel to, a country with high TB incidence, and 7 (30.4%) reported contact with an infectious TB case in Australia. Fourteen (60.9%) children had microbiologically confirmed TB; of these, 5 (21.7%) had acid-fast bacilli on microscopy, 8 (34.8%) were positive by polymerase chain reaction and 11 (47.8%) were positive by culture. All Mycobacterium tuberculosis isolates were susceptible to first-line drugs. Ten (43.5%) cases were not vaccinated with bacille Calmette-Guérin (BCG), including all cases with severe disease: 2 with disseminated (miliary) TB and 3 with tuberculous meningitis.
Conclusion:
Our findings emphasise the need for improved TB prevention and surveillance in children at high risk of exposure, particularly young children travelling to areas of high TB incidence.