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.

Pediatric tuberculosis in Northern Sardinia / Clemente, Maria Grazia; Dore, Elena; Abis, Lidia; Molicotti, Paola; Zanetti, Stefania Anna Lucia; Olmeo, Paolina; Antonucci, Roberto. - In: MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES. - ISSN 2035-3006. - 9:1(2017). [10.4084/MJHID.2017.027]

Pediatric tuberculosis in Northern Sardinia

DORE, ELENA;MOLICOTTI, Paola;ZANETTI, Stefania Anna Lucia;ANTONUCCI, Roberto
2017-01-01

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.
2017
Pediatric tuberculosis in Northern Sardinia / Clemente, Maria Grazia; Dore, Elena; Abis, Lidia; Molicotti, Paola; Zanetti, Stefania Anna Lucia; Olmeo, Paolina; Antonucci, Roberto. - In: MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES. - ISSN 2035-3006. - 9:1(2017). [10.4084/MJHID.2017.027]
File in questo prodotto:
File Dimensione Formato  
Clemente_MG_Pediatric_tuberculosis_in_Northern.pdf

non disponibili

Tipologia: Versione editoriale (versione finale pubblicata)
Licenza: Creative commons
Dimensione 1.05 MB
Formato Adobe PDF
1.05 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/174141
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 2
social impact