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Tuberculosis in children younger than five years old: New York City
C R Driver1, J J Luallen, W E Good
1Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Insights
Tuberculosis in young children often involves foreign-born individuals. Improving contact tracing and testing high-risk children is crucial for preventing pediatric tuberculosis (TB) infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) remains a significant global health concern, particularly affecting vulnerable populations.
- Pediatric TB presents unique diagnostic and epidemiological challenges.
- Understanding the transmission patterns in young children is vital for effective control strategies.
Purpose of the Study:
- To describe the epidemiology of tuberculosis in children under five years of age in New York City.
- To identify key prevention strategies for pediatric tuberculosis.
- To highlight the importance of source case identification in managing childhood TB.
Main Methods:
- Retrospective review of medical and health department records for children under five with suspected or confirmed tuberculosis.
- Data collected from January 1992 to June 1992 in New York City.
- Analysis of demographic factors, foreign-born status, source case identification, and human immunodeficiency virus (HIV) status.
Main Results:
- Forty-seven children were treated for tuberculosis.
- A significant proportion (62%) were foreign-born or had foreign-born caretakers.
- Source cases were identified in 21% of children, with the adult source diagnosed prior to the child in most instances.
- Limited availability of HIV testing results for both children and adult source cases.
Conclusions:
- Pediatric tuberculosis in New York City during this period disproportionately affected foreign-born children and those with foreign-born caretakers.
- Enhanced contact tracing and proactive testing of high-risk children are recommended for prevention.
- Clinical diagnosis is common, underscoring the importance of identifying the source case for appropriate treatment and management.
Abstract:
We examined medical and health department records for children < 5 years of age with suspected or confirmed tuberculosis reported to the New York City Health Department from January, 1992, through June, 1992, in order to describe the epidemiology of tuberculosis in young children and identify prevention strategies. Forty-seven children were treated for suspected or confirmed tuberculosis. Sixty-two percent (21 of 34) were foreign-born (n = 11) or had foreign-born caretakers (n = 10). A source case was found for 10 of 47 (21%) children; for 8 the adult source was diagnosed before the child. One child was human immunodeficiency virus-seropositive, however, 83% of children and 70% of adult source cases did not have human immunodeficiency virus test results available. Health care providers should test children at high risk for tuberculosis infection as recommended by the American Academy of Pediatrics and improve contact tracing to identify children exposed to adults with tuberculosis. Because most cases of tuberculosis in children are diagnosed clinically rather than by isolating Mycobacterium tuberculosis, identification of the source case is important for selecting appropriate treatment.