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Paediatric management of a tuberculosis outbreak in an Irish Direct Provision Centre
Rebecca Finnegan1, Anna Stanzelova2, Tiarnan Verbruggen2
1Department of Paediatrics, Galway University Hospital, Galway, Ireland. Rebeccafinnegan2@icloud.com.
Insights
Tuberculosis screening in Ireland
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Pediatric Medicine
Background:
- Direct Provision centers in Ireland house asylum seekers, facing challenges like overcrowding.
- Living conditions in Direct Provision may increase health risks for vulnerable populations, including children.
- Tuberculosis (TB) is a significant public health concern, particularly in congregate settings.
Purpose of the Study:
- To outline the protocol for contact tracing and management of latent tuberculosis infection in children.
- To assess the incidence and management of latent TB infection in pediatric residents of a Direct Provision center.
- To highlight the health risks associated with Direct Provision for children.
Main Methods:
- Retrospective case series of 82 children residing in a Direct Provision center.
- Contact tracing and risk assessment for latent tuberculosis infection following an adult TB case.
- Treatment of latent TB infection with isoniazid for 6-9 months.
Main Results:
- Twenty-two children (26.8%) were identified at risk of TB infection, all asymptomatic.
- Sixteen children (20%) received treatment for latent TB infection.
- Treatment compliance was high with no reported side effects.
Conclusions:
- Direct Provision facilities pose risks to children's health, including exposure to infectious diseases like TB.
- Effective contact tracing and management of latent TB infection are crucial in this setting.
- Improving living conditions and implementing initial migrant screening are essential public health measures.
Abstract:
Direct Provision in Ireland provides basic needs of food and shelter to asylum seekers while their refugee status is processed. There are a number of issues associated with living conditions in these centres including overcrowding, nutrition and play facilities (1,2). This article outlines the protocol of contact tracing and management of latent tuberculosis infection in the paediatric setting after a confirmed adult case of tuberculosis within a Direct Provision centre in Ireland. This is a retrospective case series of 82 children living in the centre. Twenty-two children were deemed at risk of infection, all asymptomatic. Sixteen children (20%) were treated for possible latent tuberculosis infection with isoniazid for 6-9 months; compliance was good with no side effects reported. This article highlights the risk to vulnerable populations, especially children, when residing in Direct Provision facilities. Initial migrant screening on entry is essential, in addition to improving living conditions and time spent by families in this living environment.
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