Risk of infection and disease progression in children exposed to tuberculosis at home, Colombia.

Autor: Benjumea-Bedoya D; Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.; Corporación Universitaria Remington, Grupo de Investigación en Salud Familiar y Comunitaria, Medellín, Colombia., Marín DM; Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.; Universidad Pontificia Bolivariana, Medellín, Colombia., Robledo J; Universidad Pontificia Bolivariana, Medellín, Colombia.; Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia., Barrera LF; Universidad de Antioquia, Grupo de Inmunología Celular e Inmunogenética (GICIG), Medellín, Colombia., López L; Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.; Universidad Pontificia Bolivariana, Medellín, Colombia., Del Corral H; Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia., Ferro BE; Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia.; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia., Villegas SL; Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia.; Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany., Díaz ML; Universidad del Cauca, Grupo de Inmunología y Enfermedades Infecciosas, Popayán, Colombia., Rojas CA; Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia., García LF; Universidad de Antioquia, Grupo de Inmunología Celular e Inmunogenética (GICIG), Medellín, Colombia., Arbeláez MP; Universidad de Antioquia, Grupo de Epidemiología, Medellín, Colombia.
Jazyk: angličtina
Zdroj: Colombia medica (Cali, Colombia) [Colomb Med (Cali)] 2019 Dec 30; Vol. 50 (4), pp. 261-274. Date of Electronic Publication: 2019 Dec 30.
DOI: 10.25100/cm.v50i4.4185
Abstrakt: Aim: To assess the risk of tuberculosis (infection and disease) in children less than 15 years' old who are household contacts of pulmonary tuberculosis patients in three Colombian cities (Medellín, Cali, and Popayán).
Methods: A cohort of 1,040 children household contacts of 380 adults with smear-positive pulmonary tuberculosis was followed up for 24 months. Study period 2005-2009.
Results: Tuberculin skin test was positive (≥10 mm) in 43.7% (95% CI: 39.2-48.2). Tuberculin skin test positivity was associated with age 10-14 years (Prevalence Ratio -PR= 1.43, 95% CI: 1.1-1.9), having a BCG vaccine scar (PR= 1.52, 95% CI: 1.1-2.1), underweight, closer proximity to the index case and exposure time >3 months. The annual risk of infection (tuberculin skin test induration increase of 6 mm or more per year) was 17% (95% CI: 11.8-22.2) and was associated with a bacillary load of the adult index case (Relative Risk -RR= 2.12, 95% CI: 1.0-4.3). The incidence rate of active tuberculosis was 12.4 cases per 1,000 persons-year. Children <5 years without BCG vaccine scar had a greater risk of developing active disease (Hazard Ratio -HR= 6.00, 95% CI: 1.3-28.3) than those with scar (HR= 1.33, 95% CI: 0.5-3.4). The risk of developing active tuberculosis augmented along with the increase from initial tuberculin skin test (tuberculin skin test 5-9 mm HR= 8.55, 95% CI: 2.5-29.2; tuberculin skin test ≥10 mm HR= 8.16, 95% CI: 2.0-32.9).
Conclusions: There is a need for prompt interruption of adult-to-children tuberculosis transmission within households. Conducting proper contact investigation and offering chemoprophylaxis to infected children could reduce tuberculosis transmission.
Competing Interests: Conflict of Interest: None of the authors have conflicts of interest relevant to this article to disclose.
(Copyright © 2019 Universidad del Valle.)
Databáze: MEDLINE
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