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This study on 350 children with occult tuberculosis infection found Mycobacterium tuberculosis in 8.5% of gastric aspirates. Treatment with two drugs over 12-18 months was administered, with chest X-rays showing calcification in 20.8% of cases.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Public Health
Background:
- Occult tuberculous infection presents diagnostic challenges in children.
- Early identification and treatment are crucial to prevent disease progression.
Purpose of the Study:
- To evaluate the diagnostic yield of gastric aspirates for Mycobacterium tuberculosis in children with occult tuberculous infection.
- To assess the long-term radiological outcomes and treatment strategies for these children.
Main Methods:
- Review of 350 New Zealand children diagnosed with occult tuberculous infection.
- Collection and culture of three gastric aspirates per child for Mycobacterium tuberculosis and Mycobacterium bovis.
- Follow-up chest X-rays to monitor for calcification over 2-5 years.
- Treatment regimens included isoniazid with PAS or rifampicin for 12 or 18 months.
Main Results:
- Mycobacterium tuberculosis was isolated from 8.5% of gastric aspirates; the rate was 10.9% in BCG-naive children.
- Mycobacterium bovis was not detected in any samples.
- Chest X-rays revealed calcification in 20.8% of cases initially showing normal results.
Conclusions:
- Gastric aspiration is a valuable diagnostic tool for occult tuberculosis in children.
- Long-term radiological follow-up is important to detect sequelae.
- Effective two-drug regimens are essential for managing pediatric tuberculous infection.
Abstract:
Three hundred and fifty New Zealand children with occult tuberculous infection are reviewed. Ninety four had received BCG vaccine previously. Three hundred and forty were admitted to hospital and 3 gastric aspirations were obtained from each child and cultured for tubercle bacilli. Mycobacterium tuberculosis was isolated from 1 or more aspirates in 29 (8.5%) of the children. Excluding those who had received BCG the isolation rate was 10.9%. Mycobacterium bovis was not cultured from any child. X-rays of the chest which were initially normal showed calcification after 2 to 5 years in 73 (20.8%) cases. The 350 children were treated with 2 drugs, during the early years isoniazid and PAS and in the past 3 years isoniazid and rifampicin in standard dosage for either 12 or 18 months. The reasons for treating these children are discussed.