TY - JOUR AU - Clemente, Maria Grazia AU - Dore, Elena AU - Abis, Lidia AU - Molicotti, Paola AU - Zanetti, Stefania AU - Olmeo, Paolina AU - Antonucci, Roberto PY - 2017/04/15 Y2 - 2024/03/28 TI - PEDIATRIC TUBERCULOSIS IN THE NORTH SARDINIA JF - Mediterranean Journal of Hematology and Infectious Diseases JA - Mediterr J Hematol Infect Dis VL - 9 IS - 1 SE - Original Articles DO - 10.4084/mjhid.2017.027 UR - https://www.mjhid.org/mjhid/article/view/2017.027 SP - e2017027 AB - <p><strong><span style="font-family: Times New Roman; font-size: medium;">Background and Objectives:</span></strong><span style="font-family: Times New Roman; font-size: medium;"> 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.</span></p><p><strong><span style="font-family: Times New Roman; font-size: medium;">Design:</span></strong><span style="font-family: Times New Roman; font-size: medium;"> 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. </span></p><p><strong><span style="font-family: Times New Roman; font-size: medium;">Results:</span></strong><span style="font-family: Times New Roman; font-size: medium;"> Of the 246 children </span><span style="font-family: Times New Roman; font-size: medium;">(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&lt;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.</span></p><p><strong><span style="font-family: Times New Roman; font-size: medium;">Conclusions:</span></strong><span style="font-family: Times New Roman; font-size: medium;"> 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.</span></p><p> </p> ER -