Original Articles
Vol. 9 No. 1 (2017): Review, Original Articles, Case Reports
https://doi.org/10.4084/mjhid.2017.027

PEDIATRIC TUBERCULOSIS IN THE NORTH SARDINIA

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Received: October 26, 2016
Accepted: March 27, 2017
Published: April 15, 2017
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tuberculosis exposed, latent tuberculosis infection, active tuberculosis infection, multi-drug resistant tuberculosis
Infectious Diseases

Authors

Maria Grazia Clemente
mgclemente@uniss.it
http://orcid.org/0000-0002-4586-3868
University of Sassari, Italy, Italy.
Elena Dore
Lidia Abis
Paola Molicotti
Stefania Zanetti
Paolina Olmeo
Roberto Antonucci

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.

 

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“PEDIATRIC TUBERCULOSIS IN THE NORTH SARDINIA” (2017) Mediterranean Journal of Hematology and Infectious Diseases, 9(1), p. e2017027. doi:10.4084/mjhid.2017.027.