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Tuberculosis infection in children visiting friends and relatives in countries with high incidence of tuberculosis: A
Antoni Soriano-Arandes1, Joan A Caylà2, Alessandra Queiroga Gonçalves3,4
1Unitat de Patologia Infecciosa i Immunodeficiències Pediàtriques, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron.
Insights
Children visiting family in high-tuberculosis countries may be at risk for latent tuberculosis infection (LTBI). This study investigated TB incidence and risk factors in these pediatric populations.
Area of Science:
- Pediatric infectious diseases
- Global public health
- Epidemiology
Background:
- Tuberculosis (TB) remains a significant global infectious disease.
- Paediatric TB in low-incidence countries primarily affects children of immigrants.
- Travel to countries of origin for visiting friends and relatives (VFR) poses a risk of Mycobacterium tuberculosis exposure.
Purpose of the Study:
- To estimate the incidence rate of latent tuberculosis infection (LTBI) and active TB in children traveling to high-incidence countries.
- To identify risk factors associated with LTBI and TB acquisition in this pediatric population.
Main Methods:
- Prospective study involving 492 children under 15 years old, immigrants or children of immigrants, traveling to high-incidence TB countries.
- Recruitment at primary care centers or travel clinics with pre-travel questionnaires and tuberculin skin tests (TST).
- Post-travel assessment includes TST and QuantiFERON-TB Gold Plus testing to determine LTBI incidence.
Main Results:
- The study aims to estimate the incidence rate of LTBI per individual/month and person/year, stratified by country visited and age group.
- Risk factors for LTBI and TB will be analyzed based on collected sociodemographic, epidemiological, and clinical data.
Conclusions:
- Understanding TB transmission risks during VFR travel is crucial for targeted prevention strategies in immigrant children.
- This research will inform public health interventions to reduce the burden of TB in vulnerable pediatric populations.
Introduction:
Tuberculosis (TB) is a global infectious disease. In low-incidence countries, paediatric TB affects mostly immigrant children and children of immigrants. We hypothesize that these children are at risk of exposure to Mycobacterium tuberculosis when they travel to the country of origin of their parents to visit friends and relatives (VFR). In this study, we aim to estimate the incidence rate and risk factors associated to latent tuberculosis infection (LTBI) and TB in VFR children.
Methods And Analysis:
A prospective study will be carried out in collaboration with 21 primary health care centres (PCC) and 5 hospitals in Catalonia, Spain. The study participants are children under 15 years of age, either immigrant themselves or born to immigrant parents, who travel to countries with high incidence of TB (≥ 40 cases/100,000 inhabitants). A sample size of 492 children was calculated. Participants will be recruited before traveling, either during a visit to a travel clinic or to their PCC, where a questionnaire including sociodemographic, epidemiological and clinical data will be completed, and a tuberculin skin test (TST) will be performed and read after 48 to 72 hours; patients with a positive TST at baseline will be excluded. A visit will be scheduled eight to twelve-weeks after their return to perform a TST and a QuantiFERON-TB Gold Plus test. The incidence rate of LTBI will be estimated per individual/month and person/year per country visited, and also by age-group.
Ethics And Dissemination:
The study protocol was approved by the Clinical Research Ethics Committee of the Hospital Universitari Mútua Terrassa (code 02/16) and the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (code P16/094). Articles will be published in indexed scientific journals.
Trial Registration:
Clinical-Trials.gov: NCT04236765.
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