TUBERCULOSIS: USA: Many US children with TB have international connections
Winston CA.Pediatrics. 2012:130:e1425-1432.
December 7, 2012
Most children diagnosed in the United States with tuberculosis have some type of international connection, which is likely how they were exposed to the disease, according to study data published online this week.
They said about three-quarters of the 2,660 children diagnosis with TB were either born outside the United States or had traveled outside the United States, and half of these patients were adolescent age or older. Many of the patients — about 66% — had parents who were born outside of the country.Carla A. Winston, PhD, MA, and HeatherJ. Menzies, MD, MPH, of the CDC’s Division of Tuberculosis Prevention, reported on data from the CDC’s National TB Surveillance System from 2008-2010 and also included 2009 data on parents and/or guardians who had foreign ties.
“TB remains a major cause of illness and death worldwide, and our findings highlight the impact of this global epidemic on children and adolescents in the United States. Attention to TB prevention is needed to avoid disease and suffering in children,” Winston told Infectious Diseases in Children. “Risk for TB should be assessed during routine health care encounters to identify children who may benefit from TB testing.”
Although the researchers noted some study limitations, including lack of information on contacts with international visitors, they said their research may indicate some targeted groups for intervention and prevention efforts.
“The most effective and cost-effective strategy to prevent future cases of disease in foreign-born individuals is to diagnose and treat latent TB infection (LTBI) at or shortly after entry into a low-prevalence nation,” according to an accompanying editorial written by Andrea T. Cruz, MD, of The Tuberculosis Initiative of Texas Children’s Hospital, Houston, and colleagues.
After service in the British SAS Regiment the author became a physician and then an orthopaedic surgeon.
He has held professorial positions in Canada, Vietnam and the United States, practiced and taught orthopaedic surgery in three continents and in several wars.
He has extensive experience as an expert witness in court. Somewhere along the way, time was found to operate a four hundred acre mixed farm, a one hundred seat restaurant and to obtain a licence as a flying instructor.
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