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Incidence rates, clinical features, and case identification of pediatric tuberculosis in Alaska
1Alaska Division of Public Health, Section of Maternal, Child, and Family Health, Epidemiology and Evaluation Unit, Anchorage 99501, USA. gess100w@wonder.em.cdc.gov
Insights
Pediatric tuberculosis is a significant concern in Alaska, with Alaska Natives facing a substantially higher risk. School screenings are effective for identifying new cases of this serious disease.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Tuberculosis (TB) remains a global health challenge, particularly in vulnerable populations.
- Pediatric TB presents unique diagnostic and management considerations.
- Alaska has historically faced higher TB incidence rates compared to the general US population.
Purpose of the Study:
- To determine the incidence rates of pediatric tuberculosis in Alaska.
- To describe the clinical features of tuberculosis in children aged 0-14 years in Alaska.
- To identify the primary sources of case identification for pediatric tuberculosis in the state.
Main Methods:
- A retrospective analysis of all pediatric tuberculosis cases (0-14 years) reported in Alaska from 1987 to 1994.
- Population-based study utilizing data from the Alaska Division of Public Health.
- Calculation of incidence rates and relative risks by race.
Main Results:
- An incidence rate of 5.8 per 100,000 children per year was observed.
- Alaska Natives and individuals of other non-white races exhibited significantly increased risk (RR 65 and 21, respectively) compared to whites.
- School screening identified 23% of cases, while contact investigations identified the majority.
Conclusions:
- Alaska experiences a high burden of pediatric tuberculosis, with non-white race being a significant risk factor.
- Targeted interventions and enhanced surveillance are crucial for this population.
- Mandatory school screening demonstrated utility in identifying pediatric tuberculosis cases.
Setting:
The population of Alaska.
Objective:
To determine incidence rates, clinical features, and source of case identification for pediatric tuberculosis in Alaska.
Design:
A state-wide, population-based, retrospective analysis of all cases of tuberculosis among children 0 to 14 years of age reported to the Alaska Division of Public Health during 1987-1994.
Results:
Seventy children with tuberculous disease were identified for an incidence rate of 5.8/100000/year. Compared to whites, Alaska Natives (relative risk [RR], 65; 95% confidence interval [CI], 20 to 207) and people of other races (RR, 21; 95% CI, 5.6 to 79) had an increased risk of tuberculosis. Clinical features did not differ by race. Twenty-three of 45 persons with at least one specimen collected had a positive culture result, including three with isoniazid-resistant strains. While most cases were identified through contact investigations, 23% were identified through required school screening.
Conclusion:
Alaska has a high rate of pediatric tuberculosis, with non-white race identified as a risk factor. Required school screening proved useful for case identification.