Underuse of effective measures to prevent and manage pediatric tuberculosis in the United States

Mark N. Lobato, Sumi J. Sun, Patrick K. Moonan, Stephen E. Weis, Lisa Saiman, Audrey A. Reichard, Kristina Feja

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: To characterize problems with prevention and management of pediatric tuberculosis (TB) and latent TB infection (LTBI). Design: A multisite, cross-sectional study using data from medical records and public health logs to categorize and define use of routine prevention practices in managing pediatric TB and LTBI. Setting: Four areas of the United States. Participants: Children younger than 5 years diagnosed with TB from January 1, 2002, through December 31, 2004, and children with LTBI reported during a continuous 12-month period in 2003 to 2004. Main Exposure: Mycobacterium tuberculosis. Main Outcome Measures: Underuse or nonuse of standard medical and public health interventions. Results: Almost 40% of children had a TB risk factor related to their country of birth, parental origin, or travel to a country with a high incidence of TB. Children having LTBI were less likely than those having TB to complete treatment (53.7% vs 88.6%, respectively). Almost half (46.3%) of the children with TB came to medical attention late in their course when they already had symptoms. Among 63 adult source patients, 19 (30.2%) previously had LTBI but were not treated, and none of the 40 foreign-born source patients were known to have been evaluated for TB before entry into the United States. Conclusions: Prevention efforts are unsatisfactory to prevent TB in children. Effective interventions such as treatment of LTBI and TB evaluation of adult immigrants remain less than optimal.

Original languageEnglish
Pages (from-to)426-431
Number of pages6
JournalArchives of Pediatrics and Adolescent Medicine
Issue number5
StatePublished - May 2008


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