Saturday, 22 December 2012

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.

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