Impact of Immigration on Pulmonary Tuberculosis in Spanish Children
| Autor: | María Isabel de José, Goosen López, Ana Méndez-Echevarría, Francisco Javier Aracil, Fernando Baquero-Artigao, María Jesús García-Miguel, Fernando del Castillo, Teresa Del Rosal |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Pediatrics Tuberculosis Adolescent Population Antitubercular Agents Drug resistance Tuberculous meningitis Drug Resistance Bacterial Epidemiology Isoniazid medicine Humans Child education Tuberculosis Pulmonary Retrospective Studies education.field_of_study business.industry Incidence (epidemiology) Infant Newborn Infant Retrospective cohort study Emigration and Immigration medicine.disease Surgery Infectious Diseases Spain Child Preschool Tuberculosis Meningeal Pediatrics Perinatology and Child Health Female Contact Tracing business Contact tracing |
| Zdroj: | Pediatric Infectious Disease Journal. 29:648-651 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0b013e3181d5da11 |
| Popis: | Background: Tuberculosis causes significant morbidity and mortality worldwide. In the last years, international travel and immigration have led to important changes in the epidemiology of this disease. Drug resistance has emerged as an important threat to tuberculosis control. Data regarding the impact of immigration and the incidence of drug-resistant strains in children are lacking. Methods: Retrospective review of patients diagnosed with pulmonary tuberculosis at La Paz Children's Hospital in a 30-year period. Data were collected with regard to the clinical, radiologic, microbiologic, and demographic characteristics of patients, and data from the 3 decades of the study were compared using χ 2 test and Fisher exact test. Results: A total of 507 cases of tuberculosis were identified, 414 of which had pulmonary involvement. During the study, there was a significant decrease in tuberculous meningitis: 10.4% in 1978-1987, 5.6% in 1988-1997, and 2.9% in 1998-2007 (P < 0.05). The most frequent reason for a consultation was case contact investigation. The adult source case was identified in 64% of patients. We observed an increase in extrafamilial contacts (8% in 1978-1987 and 18% in 1998-2007, P < 0.01), including 4 cases of immigrant caretakers. Tuberculosis in immigrant children has increased with time: 2% in the period 1978-1987, 6% in 1988-1997, and 46% in 1998-2007 (P < 0.001). The primary resistance rate to isoniazid in our population was 6.5%. Conclusions: Tuberculosis in our area continues to be a major health problem, especially among foreign-bom children. As drug-resistant strains are increasing, initial therapy with 4 drugs is recommended in our population. |
| Databáze: | OpenAIRE |
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