Pediatric tuberculosis in the metropolitan area of Rio de Janeiro
| Autor: | Rafaela Baroni Aurilio, Afrânio Lineu Kritski, Anna Cristina C. Carvalho, Maria de Fatima Bazhuni Pombo Sant’Anna, Clemax Couto Sant'Anna, Adriana S. R. Moreira, Ana Lúcia Miceli, Ana Paula Quintanilha, Suzana Aparecida Greggi de Alcantara, Christiane Mello Schmidt, Pedro da Silva Martins, Lorrayne Isidoro-Gonçalves, Terezinha Martire, Laura Saderi, Selma Maria de Azevedo Sias, Carla Fernandes dos Santos Lara, Giovanni Sotgiu, Ana Paula Barbosa, Giovanni Battista Migliori, Luiza Martins Vieira, André Luis Bezerra, Claudete Aparecida Araújo Cardoso |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty Tuberculosis Adolescent 030106 microbiology Treatment outcome MEDLINE Antitubercular Agents HIV Infections Microbial Sensitivity Tests lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Prevalence Medicine Humans lcsh:RC109-216 030212 general & internal medicine Cities Child GeneralLiterature_REFERENCE(e.g. dictionaries encyclopedias glossaries) Tuberculosis Pulmonary Retrospective Studies business.industry Infant Retrospective cohort study General Medicine Mycobacterium tuberculosis medicine.disease Metropolitan area Pediatric tuberculosis Infectious Diseases Treatment Outcome Family medicine Child Preschool Female business Brazil |
| Zdroj: | International Journal of Infectious Diseases, Vol 98, Iss, Pp 299-304 (2020) |
| ISSN: | 1878-3511 |
| Popis: | Aim: To evaluate the clinical characteristics, diagnostic approach, and treatment outcomes of tuberculosis (TB) in children living in a high-burden metropolitan area. Methods: This was a retrospective study, based on a medical chart review, involving children under 15 years old treated for TB between 2007 and 2016, in four primary health units (PHU) and three reference centers (RC) in five cities of Rio de Janeiro metropolitan area. Factors associated with TB treatment setting, microbiological diagnosis, and treatment outcomes were evaluated. Results: A total of 544 children were enrolled; 71% were treated in PHU, 36% were under 5 years old, and 72% had pulmonary TB (PTB). The HIV prevalence was 10% (31/322). Fifty-three percent had at least one microbiological test for TB, 68% of them (196/287) had TB confirmed. Among 222 children with previous TB contact, information on LTBI was available for 78 (35%), and only 17% (13/78) were treated. Extrapulmonary TB (56% vs 32%), microbiologically confirmed TB (77% vs 60%), and HIV positivity (18.5% vs 4.0%) were significantly more frequent in RC. Treatment in RC (odds ratio (OR) 3.08, 95% confidence interval (CI) 1.74–5.44) and PTB (OR 2.47, 95% CI 1.34–4.56) were independently associated with a microbiological diagnosis of TB. The treatment success rate was 85%. In the logistic regression analysis, HIV-infected children had a 2.5-fold higher risk of an unfavorable outcome (OR 2.53, 95% CI 1.0–6.38; p = 0.05). Conclusions: Opportunities for TB prevention and early TB treatment are missed due to suboptimal close contact screening. Microbiological diagnosis of TB and drug susceptibility testing in children should be made available through more sensitive and accessible tests. |
| Databáze: | OpenAIRE |
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