PEDIATRIC TUBERCULOSIS IN NORTHERN BUENOS AIRES AREA DURING THE PERIOD 2001-2007

NORA MORCILLO; BELÉN IMPERIALE

Plovdiv

Congreso; 29 Congreso Anual de la Sociedad Europea de Micobacteriología (ESM); 2008

Sociedad Europea de Micobacteriología (ESM)

Introduction. Pediatric tuberculosis (PTB) worldwide varies significantly regarding to the burden of the disease in different countries. Children with TB may represent 10 %-20 % of TB, approximately 3.1 million children fewer than 15 years of age. Purpose. To describe the PTB incidence in the Northern Buenos Aires (NBA) and to compare the proportions of both children and adults infected by multidrug-resistant Mycobacterium tuberculosis (MDR) strains. Methods. It was an observational, retrospective study. Data were collected from 2001to 2007 from medical and laboratory records of the TB Control Program (TBCP). Results. During this period 7,220 TB cases were reported being 2,128 (29.5%) confirmed by culture. A total of 431 (6.0%) out of 7,220 cases occurred in children. From 136 (31.6%) PTB cases the isolate was obtained by culture, the median age in children was 12 years (95%CI: 12.0-14.0; range: 0.2-15.0) and 120 (88.2%) presented a respiratory localization of the disease. Nine (6.6%) children were infected by a MDR isolate: 6.7% (6/89) had not had a previous treatment history (NTP) but in 15.4% (4/26) it was possible to identify the infectious contact (CON), while 14.3% (3/21) of the cases occurred in children with previous treatment history (PTP). In adults these figures were: NTP, 4.0% (56/1383); CON, 12.2% (6/49) and PTP, 12.5% (70/561) respectively. There were no significant differences between proportions of MDR in children and adults: NTP (0.3359), CON (0.9752), PTP (0.8766), besides children were at higher risk to develop a drug-resistant TB (odds ratio: 17.55, 95%CI: 6.41-48.04). Household TB contacts were simultaneously identified and related to 13 (9.6%) PTB cases by molecular epidemiology studies.  Culture and drug-susceptibility testing to determine the resistance pattern of the isolates should be recommended to optimize therapeutic efforts addressed for PTB cases, which is a useful parameter for assessing the impact of TBCP activities.