Tuberculosis contact investigation results among paediatric contacts in low-incidence settings in Finland

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http://hdl.handle.net/10138/340314

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Kontturi , A , Kekomäki , S , Ruotsalainen , E & Salo , E 2021 , ' Tuberculosis contact investigation results among paediatric contacts in low-incidence settings in Finland ' , European journal of pediatrics , vol. 180 , no. 7 , pp. 2185-2192 . https://doi.org/10.1007/s00431-021-04000-7

Title: Tuberculosis contact investigation results among paediatric contacts in low-incidence settings in Finland
Author: Kontturi, Antti; Kekomäki, Satu; Ruotsalainen, Eeva; Salo, Eeva
Contributor organization: Children's Hospital
HUS Children and Adolescents
University of Helsinki
Helsinki University Hospital Area
Clinicum
HUS Inflammation Center
Infektiosairauksien yksikkö
Date: 2021-07
Language: eng
Number of pages: 8
Belongs to series: European journal of pediatrics
ISSN: 0340-6199
DOI: https://doi.org/10.1007/s00431-021-04000-7
URI: http://hdl.handle.net/10138/340314
Abstract: Tuberculosis (TB) risk is highest immediately after primary infection, and young children are vulnerable to rapid and severe TB disease. Contact tracing should identify infected children rapidly and simultaneously target resources effectively. We conducted a retrospective review of the paediatric TB contact tracing results in the Hospital District of Helsinki and Uusimaa from 2012 to 2016 and identified risk factors for TB disease or infection. Altogether, 121 index cases had 526 paediatric contacts of whom 34 were diagnosed with TB disease or infection. The maximum delay until first contact investigation visit among the household contacts under 5 years of age with either TB disease or infection was 7 days. The yield for TB disease or infection was 4.6% and 12.8% for household contacts, 0.5% and 0% for contacts exposed in a congregate setting and 1.4% and 5.0% for other contacts, respectively. Contacts born in a TB endemic country (aOR 3.07, 95% CI 1.10-8.57), with household exposure (aOR 2.96, 95% CI 1.33-6.58) or a sputum smear positive index case (aOR 3.96, 95% CI 1.20-13.03) were more likely to have TB disease or infection. Conclusions: Prompt TB investigations and early diagnosis can be achieved with a well-organised contact tracing structure. The risk for TB infection or disease was higher among contacts with household exposure, a sputum smear positive index case or born in a TB endemic country. Large-scale investigations among children exposed in congregate settings can result in a very low yield and should be cautiously targeted. What is Known: Vulnerable young children are a high priority in contact tracing and should be evaluated as soon as possible after TB exposure What is New: Prompt investigations for paediatric TB contacts and early diagnosis of infected children can be achieved with a well-organised contact tracing structure Large-scale investigations among children exposed in congregate settings can result in a very low yield and should be cautiously targeted
Subject: Tuberculosis
Vulnerable young children
Paediatric TB contact tracing
3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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