Risk factors for infection and disease in child contacts of multidrug-resistant tuberculosis: a cross-sectional study
Identifieur interne : 002365 ( Main/Exploration ); précédent : 002364; suivant : 002366Risk factors for infection and disease in child contacts of multidrug-resistant tuberculosis: a cross-sectional study
Auteurs : James A. Seddon [Afrique du Sud, Royaume-Uni] ; Anneke C. Hesseling [Afrique du Sud] ; Peter Godfrey-Faussett [Royaume-Uni] ; Katherine Fielding [Royaume-Uni] ; H Simon Schaaf [Afrique du Sud]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2013.
Abstract
Young children exposed to
Cross-sectional study; all children aged < 5 years, routinely referred per local guidelines to the provincial specialist MDR-TB clinic, Western Cape Province, South Africa, following identification as contacts of adult MDR-TB source cases, were eligible for enrolment from May 2010 through April 2011. Demographic, clinical and social characteristics were collected. All children underwent HIV and tuberculin skin testing.
Of 228 children enrolled (median age: 30 months), 102 (44.7%) were classified as infected. Of these, 15 (14.7%) had TB disease at enrolment. Of 217 children tested for HIV, 8 (3.7%) were positive. In adjusted analysis, child’s age (AOR: 1.43; 95% CI: 1.13-1.91; p = 0.002) and previous TB treatment history (AOR: 2.51; 95% CI: 1.22-5.17; p = 0.01) were independent risk factors for infection. Increasing age of the MDR-TB source case (AOR: 0.67; 95% CI: 0.45-1.00; p = 0.05) was protective and source case alcohol use (AOR: 2.59; 95% CI: 1.29-5.22; p = 0.007) was associated with increased odds of infection in adjusted analysis. Decreasing age of the child (p = 0.01) and positive HIV status (AOR: 25.3; 95% CI: 1.63-393; p = 0.01) were associated with prevalent TB disease.
A high proportion of children exposed to MDR-TB are infected or diseased. Early contact tracing might provide opportunities to prevent the progression to TB disease in children identified as having been exposed to MDR-TB.
Url:
DOI: 10.1186/1471-2334-13-392
PubMed: 23977834
PubMed Central: 3765928
Affiliations:
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Seddon</name><affiliation wicri:level="1"><nlm:aff id="I1">Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Room 0085, P. O. Box 19063, Tygerberg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Room 0085, P. O. Box 19063, Tygerberg</wicri:regionArea><wicri:noRegion>Tygerberg</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hesseling, Anneke C" sort="Hesseling, Anneke C" uniqKey="Hesseling A" first="Anneke C" last="Hesseling">Anneke C. Hesseling</name><affiliation wicri:level="1"><nlm:aff id="I1">Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Room 0085, P. O. Box 19063, Tygerberg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Room 0085, P. O. Box 19063, Tygerberg</wicri:regionArea><wicri:noRegion>Tygerberg</wicri:noRegion></affiliation></author><author><name sortKey="Godfrey Faussett, Peter" sort="Godfrey Faussett, Peter" uniqKey="Godfrey Faussett P" first="Peter" last="Godfrey-Faussett">Peter Godfrey-Faussett</name><affiliation wicri:level="3"><nlm:aff id="I2">Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Fielding, Katherine" sort="Fielding, Katherine" uniqKey="Fielding K" first="Katherine" last="Fielding">Katherine Fielding</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Schaaf, H Simon" sort="Schaaf, H Simon" uniqKey="Schaaf H" first="H Simon" last="Schaaf">H Simon Schaaf</name><affiliation wicri:level="1"><nlm:aff id="I1">Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Room 0085, P. O. Box 19063, Tygerberg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Room 0085, P. O. Box 19063, Tygerberg</wicri:regionArea><wicri:noRegion>Tygerberg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Tygerberg Children’s Hospital, Tygerberg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Tygerberg Children’s Hospital, Tygerberg</wicri:regionArea><wicri:noRegion>Tygerberg</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Young children exposed to <italic>Mycobacterium tuberculosis</italic> have a high risk of disease progression following infection. This study aimed to determine risk factors for <italic>M. tuberculosis</italic> infection and disease in children following exposure to adults with multidrug-resistant (MDR) tuberculosis (TB).</p></sec><sec><title>Methods</title><p>Cross-sectional study; all children aged < 5 years, routinely referred per local guidelines to the provincial specialist MDR-TB clinic, Western Cape Province, South Africa, following identification as contacts of adult MDR-TB source cases, were eligible for enrolment from May 2010 through April 2011. Demographic, clinical and social characteristics were collected. All children underwent HIV and tuberculin skin testing.</p></sec><sec><title>Results</title><p>Of 228 children enrolled (median age: 30 months), 102 (44.7%) were classified as infected. Of these, 15 (14.7%) had TB disease at enrolment. Of 217 children tested for HIV, 8 (3.7%) were positive. In adjusted analysis, child’s age (AOR: 1.43; 95% CI: 1.13-1.91; p = 0.002) and previous TB treatment history (AOR: 2.51; 95% CI: 1.22-5.17; p = 0.01) were independent risk factors for infection. Increasing age of the MDR-TB source case (AOR: 0.67; 95% CI: 0.45-1.00; p = 0.05) was protective and source case alcohol use (AOR: 2.59; 95% CI: 1.29-5.22; p = 0.007) was associated with increased odds of infection in adjusted analysis. Decreasing age of the child (p = 0.01) and positive HIV status (AOR: 25.3; 95% CI: 1.63-393; p = 0.01) were associated with prevalent TB disease.</p></sec><sec><title>Conclusion</title><p>A high proportion of children exposed to MDR-TB are infected or diseased. 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Vidal-Perez</name></author><author><name sortKey="Garcia Viejo, Ma" uniqKey="Garcia Viejo M">MA Garcia-Viejo</name></author><author><name sortKey="Jaras Hernandez, Mj" uniqKey="Jaras Hernandez M">MJ Jaras-Hernandez</name></author><author><name sortKey="Lopez, O" uniqKey="Lopez O">O Lopez</name></author><author><name sortKey="Noguerado Asensio, A" uniqKey="Noguerado Asensio A">A Noguerado-Asensio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rutherford, Me" uniqKey="Rutherford M">ME Rutherford</name></author><author><name sortKey="Hill, Pc" uniqKey="Hill P">PC Hill</name></author><author><name sortKey="Maharani, W" uniqKey="Maharani W">W Maharani</name></author><author><name sortKey="Apriani, L" uniqKey="Apriani L">L Apriani</name></author><author><name sortKey="Sampurno, H" uniqKey="Sampurno H">H Sampurno</name></author><author><name sortKey="Van Crevel, R" uniqKey="Van Crevel R">R Van Crevel</name></author><author><name sortKey="Ruslami, R" uniqKey="Ruslami R">R Ruslami</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Afrique du Sud"><noRegion><name sortKey="Seddon, James A" sort="Seddon, James A" uniqKey="Seddon J" first="James A" last="Seddon">James A. Seddon</name></noRegion><name sortKey="Hesseling, Anneke C" sort="Hesseling, Anneke C" uniqKey="Hesseling A" first="Anneke C" last="Hesseling">Anneke C. Hesseling</name><name sortKey="Schaaf, H Simon" sort="Schaaf, H Simon" uniqKey="Schaaf H" first="H Simon" last="Schaaf">H Simon Schaaf</name><name sortKey="Schaaf, H Simon" sort="Schaaf, H Simon" uniqKey="Schaaf H" first="H Simon" last="Schaaf">H Simon Schaaf</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Seddon, James A" sort="Seddon, James A" uniqKey="Seddon J" first="James A" last="Seddon">James A. Seddon</name></region><name sortKey="Fielding, Katherine" sort="Fielding, Katherine" uniqKey="Fielding K" first="Katherine" last="Fielding">Katherine Fielding</name><name sortKey="Godfrey Faussett, Peter" sort="Godfrey Faussett, Peter" uniqKey="Godfrey Faussett P" first="Peter" last="Godfrey-Faussett">Peter Godfrey-Faussett</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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