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Childhood tuberculosis at a Swiss university hospital: a 2-year study
C Barazzone1, M Hofer, D Nussle
1Department of Paediatrics, Hôpital Cantonal Universitaire, Geneva, Switzerland.
Insights
Tuberculosis (TB) in children in Geneva primarily affects those from TB-endemic countries. Targeted screening and contact tracing are crucial for early detection and management of pediatric tuberculosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) remains a global health concern, particularly in endemic regions.
- Pediatric TB diagnosis and management present unique challenges.
- Understanding the epidemiology of TB in immigrant populations is vital for control.
Purpose of the Study:
- To investigate the incidence and characteristics of pediatric tuberculosis cases presenting at a Swiss hospital.
- To evaluate the effectiveness of contact screening in identifying new TB cases.
- To inform public health strategies for TB prevention in children.
Main Methods:
- Retrospective review of clinical data for children receiving antituberculous therapy over two years.
- Analysis of patient origin, disease activity, and treatment outcomes.
- Assessment of contact screening results within families.
Main Results:
- 43 pediatric TB cases were identified, all originating from non-Swiss countries.
- 58% of cases were asymptomatic at diagnosis.
- Drug-induced hepatitis occurred in 5% of patients, necessitating treatment interruption.
- Contact screening identified additional TB cases and positive medical histories in relatives.
Conclusions:
- Pediatric TB in Switzerland is strongly associated with children from countries where TB is endemic.
- Tuberculin skin testing should be prioritized for this high-risk group.
- Contact tracing is an effective tool for early detection and disease control in families.
Abstract:
The incidence of tuberculosis (TB) presenting to the University Hospital, Geneva, Switzerland, was studied over 2 years. Clinical data on all children receiving antituberculous drug therapy was collected. Of the 43 identified cases, 42% had active disease (i.e. clinical evidence of organ involvement), the remaining 58% being asymptomatic. All 43 children originated from countries other than Switzerland. Symptomatic, drug induced hepatitis necessitated temporary interruption of therapy in 2 children (5%). Contact screening yielded three new cases of pulmonary TB, three previously diagnosed cases and seven instances of a positive medical history in relatives living in other countries. Of the 34 families in this study, contact screening could not be completed in 8. The results of this study indicate that children with TB are primarily associated with families originating from countries other than Switzerland, particularly those in which TB remains endemic. Tuberculin skin testing should therefore be targeted at this group. Contact tracing has also been shown to be beneficial.