TY - JOUR
T1 - Underuse of effective measures to prevent and manage pediatric tuberculosis in the United States
AU - Lobato, Mark N.
AU - Sun, Sumi J.
AU - Moonan, Patrick K.
AU - Weis, Stephen E.
AU - Saiman, Lisa
AU - Reichard, Audrey A.
AU - Feja, Kristina
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/5
Y1 - 2008/5
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=43049144320&partnerID=8YFLogxK
U2 - 10.1001/archpedi.162.5.426
DO - 10.1001/archpedi.162.5.426
M3 - Article
C2 - 18458188
AN - SCOPUS:43049144320
SN - 1072-4710
VL - 162
SP - 426
EP - 431
JO - Archives of Pediatrics and Adolescent Medicine
JF - Archives of Pediatrics and Adolescent Medicine
IS - 5
ER -