Evelyn F Rubin, Sheila C Lucena, Marcela Bhering, Lorrayne Gonçalves, Fabiana Falcão, Margareth Dalcolmo, Giovanni B Migliori, Laura Saderi, Giovanni Sotgiu, Afrânio Kritski, Anna C C Carvalho
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引用次数: 0
Abstract
Objectives: Young contacts of pulmonary tuberculosis (TB) patients face a higher risk of TB. Still, few studies have evaluated this risk among contacts of patients with pulmonary multidrug-resistant tuberculosis (MDR-TB). This study aimed to describe the incidence rate and the prevalence of TB infection (TBI) and TB disease (TBD) in young contacts of patients with MDR-TB.
Methods: The authors retrospectively evaluated contacts of patients with pulmonary TB aged 0 to 19 for TBI and TBD in Rio de Janeiro between 2006 and 2016. Based on the drug susceptibility pattern and/or therapeutic regimen of the index case, contacts were classified into MDR-TB and non-MDR-TB contacts. A tuberculin skin test ≥ 5 mm was considered positive. Preventive therapy with isoniazid was offered to eligible contacts. Bivariate and multivariate logistic regressions estimated factors associated with TBI.
Results: 439 contacts were screened; 129 were MDR-TB and 310 were non-MDR-TB contacts. TBI prevalence was 68.2 % in MDR-TB vs. 61.9 % in non-MDR-TB contacts (p = 0.23). Tuberculin conversion was higher among MDR-TB contacts (45.5 % vs. 17.1 %; p = 0.04). TBD incidence rate was 47.7 in non-MDR-TB and 179.6 per 100,000 person-months in MDR-TB contacts (p = 0.65), for a total TBD prevalence of 2.5 %. The overall TPT completion rate was 67.2 %; 71.5 % in non-MDR-TB and 59 % in MDR-TB contacts (p = 0.04).
Conclusion: The authors identified a high prevalence of TBI among contacts of pulmonary MDR-TB and non-MDR-TB patients, with a higher tuberculin conversion rate in MDR-TB contacts, highlighting the urgency of effective TPT regimens for young contacts of patients with pulmonary MDR-TB.
期刊介绍:
Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.