Federal University of São João del-Rei, Minas Gerais, Brazil.
Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Am J Trop Med Hyg. 2019 Nov;101(5):1077-1082. doi: 10.4269/ajtmh.19-0100.
This follow-up cross-sectional study aimed to analyze the prevalence rate and risk factors related to latent tuberculosis infection (LTBI) and active tuberculosis (TB) in children aged < 15 years in contact with adults with smear-positive pulmonary TB (PTB) in a Brazilian municipality. Data were collected from interviews, clinical evaluations, chest X-rays, tuberculin skin tests, and interferon gamma release assays. The median time elapsed between diagnosis of the index case (IC) and inclusion in the study was 2.5 years (interquartile range [IQR] = 1.5-4.4) and 7.4 years (IQR = 3.8-9.7) when we reassessed the development (or not) of active TB. The median age at the time of exposure to the IC was 6.6 years (IQR = 3.3-9.4) and 14.1 years (IQR = 8.9-17.7) at the last follow-up. Of the 99 children and adolescents in contact with smear-positive PTB, 21.2% (95% CI = 14.0-29.9) were diagnosed with LTBI, and none developed active TB. There was no statistically significant difference between the LTBI and non-LTBI groups regarding demographic, socioeconomic, and epidemiological characteristics. Unlike national and international scenarios, we found a lower frequency of LTBI and no active TB among our studied patients. For better understanding of these findings, further studies might add, among other factors, host and genetic features.
本随访性横断面研究旨在分析巴西某城市与涂阳肺结核(PTB)成人接触的<15 岁儿童中潜伏性结核感染(LTBI)和活动性肺结核(TB)的流行率及其相关危险因素。数据收集来自访谈、临床评估、胸部 X 光片、结核菌素皮肤试验和干扰素-γ释放试验。从确诊索引病例(IC)到纳入研究的中位时间为 2.5 年(四分位距 [IQR] = 1.5-4.4),重新评估活动性 TB 发展(或未发展)的中位时间为 7.4 年(IQR = 3.8-9.7)。接触 IC 时的中位年龄为 6.6 岁(IQR = 3.3-9.4),最后一次随访时为 14.1 岁(IQR = 8.9-17.7)。在与涂阳 PTB 接触的 99 名儿童和青少年中,21.2%(95%CI = 14.0-29.9)被诊断为 LTBI,且均未发生活动性 TB。LTBI 组和非 LTBI 组在人口统计学、社会经济和流行病学特征方面无统计学差异。与国内外情况不同,我们发现研究患者的 LTBI 频率较低,且无活动性 TB。为了更好地理解这些发现,进一步的研究可能需要纳入宿主和遗传特征等其他因素。