A 20-Year Retrospective Study of Pediatric Tuberculosis in Two Tertiary Hospitals in Rome

Giovanni Delogu, Antonia Carla Testa, Piero Valentini, Danilo Buonsenso, Orazio Gaetano Ranno, Pamela D'Alfonso, Laura Lancella, Andrej Krzysztofiak, Angela Testa

Risultato della ricerca: Contributo in rivistaArticolo in rivista

25 Citazioni (Scopus)

Abstract

BACKGROUND:: Tuberculosis (TB) is among the top 10 causes of child death worldwide. Nevertheless, childhood disease has been neglected by tuberculosis control programs. METHODS:: Retrospective study of patients less than 16 years old diagnosed with active TB in two tertiary hospitals in Rome (Italy), between 1990 and 2009. RESULTS:: 214 cases of active tuberculosis were identified (132 definite, 82 probable). Pulmonary involvement was the most common form (75.5%), followed by lymphadenopathy (15.4%) and central nervous system TB (11%). Fever (51.86%) and cough (40%) were the most common presenting symptoms. 23.4% of children were asymptomatic on admission. Sensitivities of the tuberculin skin test and the quantiferon test were 93.4% and 97% respectively. Both tests performed in 52 children agreed in 49 cases (94%). Sensitivities for culture, Ziehl-Neelsen staining and polymerase chain reaction were 58%, 25% and 66.3% respectively. The adult source case was identified in 28% of cases. History of contact with a patient with active tuberculosis was associated with pulmonary TB (P=0.0014), while negative history of contact was associated with lymph node (P=0.0064) and central nervous system TB (P=0.05). CONCLUSIONS:: Our study emphasizes the difficulty in managing children with suspected TB, since the absence of constitutional symptoms cannot exclude TB and bacteriologic confirmation is the exception. Immunologic diagnosis can be a valuable tool to identify TB infected children since the quantiferon test showed high sensitivity in all age-groups. This is of primary importance since early identification of children with latent tuberculous infection and appropriate chemoprophylaxis represent, to date, the most important tool to reduce the burden of TB.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaTHE PEDIATRIC INFECTIOUS DISEASE JOURNAL
DOI
Stato di pubblicazionePubblicato - 2012

Keywords

  • Tuberculosis

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