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Pediatric tuberculosis in Northern Sardinia

Clemente, Maria Grazia and Dore, Elena and Abis, Lidia and Molicotti, Paola and Zanetti, Stefania Anna Lucia and Olmeo, Paolina and Antonucci, Roberto (2017) Pediatric tuberculosis in Northern Sardinia. Mediterranean Journal of Hematology and Infectious Diseases, Vol. 9 (1), e2017027. eISSN 2035-3006. Article.

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DOI: 10.4084/mjhid.2017.027

Abstract

Background and objectives: Migration flux is an increasing phenomenon in Italy, and it raises several public health issues and concerns in pediatric infectious diseases. This study investigated the clinical characteristics and outcomes of a pediatric population at high-risk for tuberculosis (TB) and the potential role of immigration as a risk factor.
Design: We performed an observational retrospective study of children referred to the only Pediatric Infectious Diseases Unit for Northern Sardinia over a 6-year-period (2009-2014). Main variables assessed included TB skin test (TST), confirmed by quantiFERON Gold in Tube test, thorax X-ray (TX), microbiological culture, direct microscopy for acid-fast bacilli and molecular assays.
Results: Of the 246 children (mean age = 5.8 ± 3.9 years) identified, 222 (90.2%) were native to Sardinia and 24 (9.8%) were immigrants. The majority of children (n=205; 83%) were TB-exposed but not infected based on a negative TST and TX. Among the TST positive group (n= 39; 16%), 19 (49%) had latent TB (TX negative), while 20 (51%) had active TB (TX positive). The percent of TST positive children was significantly higher in the immigrant than the native group (42.5% versus 14%, p<0.001). Clinical presentations included pulmonary involvement with hilar lymphadenopathy (72%), pleurisy (13,5%), lateral-cervical lymphadenopathy (9%), pneumonia with calcifications (4.5%) and disseminated TB (4.5%). One child had multidrug-resistant tuberculosis.
Conclusions: Pediatric TB represents a relevant and potentially worsening public health problem in Northern Sardinia. A strict surveillance system and appropriate treatment can prevent the most severe forms and reduce TB transmission.

Item Type:Article
ID Code:11614
Status:Published
Refereed:Yes
Uncontrolled Keywords:Tuberculosis household contacts, latent tuberculosis, active tuberculosis, multi-drug resistant tuberculosis
Subjects:Area 06 - Scienze mediche > MED/38 Pediatria generale e specialistica
Area 06 - Scienze mediche > MED/07 Microbiologia e microbiologia clinica
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Chirurgiche, Microchirurgiche e Mediche
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Biomediche
Publisher:Giuseppe Leone
eISSN:2035-3006
Deposited On:26 Apr 2017 17:19

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