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Analysis of Factors Affecting the Rate of Latent Tuberculosis Infection and Management in Pediatrics
Hee Won Ma1, Hee Soo Lee1, Ji Young Ahn2
1College of Medicine, Yeungnam University, Daegu 42415, Korea.
Insights
Managing latent tuberculosis infection (LTBI) in children is vital for reducing tuberculosis transmission. Close household contact and infectious index cases significantly increase pediatric LTBI risk and loss to follow-up.
Area of Science:
- Public Health
- Pediatrics
- Infectious Diseases
Background:
- Tuberculosis (TB) incidence remains high in South Korea, making latent tuberculosis infection (LTBI) management a key strategy.
- Pediatric LTBI is critical due to children's potential as long-term infection sources.
- Effective pediatric LTBI management requires robust contact investigation and follow-up protocols.
Purpose of the Study:
- To assess the prevalence and risk factors of LTBI in pediatric contacts screened for tuberculosis.
- To identify characteristics of index cases associated with pediatric LTBI diagnosis.
- To inform strategies for active management of pediatric tuberculosis contacts.
Main Methods:
- Retrospective study of children (0-18 years) undergoing tuberculosis contact screening from February 2012 to February 2021.
- Analysis of tuberculosis index cases and their clinical characteristics.
- Statistical analysis to determine associations between contact characteristics, index case factors, and pediatric LTBI diagnosis.
Main Results:
- Out of 350 children investigated, 68 of 247 (27.5%) were diagnosed with LTBI.
- Higher LTBI rates and loss to follow-up were observed in close household contacts.
- Index cases with sputum presence and positive acid-fast bacillus (AFB) stain were significantly related to pediatric LTBI diagnosis.
Conclusions:
- Active management of tuberculosis screening in pediatric contacts is essential.
- Particular attention should be given to older contacts and those with close family ties to infectious index cases.
- Index cases with sputum and positive AFB smears require intensified contact management to prevent pediatric LTBI.
Abstract:
The incidence of tuberculosis remains high in South Korea; the management of latent tuberculosis infection (LTBI) has become the prime target for reducing the infection rate. The management of pediatric LTBI is especially crucial because children can serve as a long-term source of infection upon developing active tuberculosis. Therefore, it is important to assess pediatric LTBI using contact investigation and follow-up. We conducted a retrospective study on children aged between 0 and 18 years who visited our hospital for tuberculosis contact screening from February 2012 to February 2021. Tuberculosis index cases and their clinical characteristics were also reviewed retrospectively. A total of 350 children were investigated, and 68 of 247 (27.5%) were diagnosed with LTBI. The rate of LTBI (r = 7.98, p < 0.001) and the risk of loss to follow-up (r = 27.038, p < 0.001) were higher in cases with close household contact. Sputum (r = 10.992, p < 0.001) and positive acid-fast bacillus (AFB) stain (r = 4.458, p = 0.001) in tuberculosis index cases were related to the diagnosis of LTBI in pediatric contacts. Active management is needed for tuberculosis screening in pediatric contacts, especially when the contacts are older and the index case is within the family, and when the index case has sputum and has tested positive for AFB smear.
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