Israel Medical Association Journal
Volume 8, Issue 1, 2006, Pages 21-26

Epidemiologic characteristics of pediatric active tuberculosis among immigrants from high to low tuberculosis-endemic countries: The Israeli experience (Article)

Chemtob D.* , Weiler-Ravell D. , Leventhal A. , Bibi H.
  • a Department of Tuberculosis and AIDS, Ministry of Health, P.O. Box 1176, Jerusalem 91010, Israel, Public Health Services, Ministry of Health, P.O. Box 1176, Jerusalem 91010, Israel
  • b Department of Tuberculosis and AIDS, Ministry of Health, P.O. Box 1176, Jerusalem 91010, Israel, Public Health Services, Ministry of Health, P.O. Box 1176, Jerusalem 91010, Israel
  • c Public Health Services, Ministry of Health, P.O. Box 1176, Jerusalem 91010, Israel
  • d Department of Pediatrics, Barzilai Medical Center, Ashkelon, Israel

Abstract

Background: During the last decade, Israel, a country with low tuberculosis rates, absorbed some 900,000 new immigrants from TB-endemic countries. Objectives: To analyze the specific impact of our screening procedures on active TB among children in Israel. Methods: We conducted a retrospective analysis of epidemiologic and clinical data of all children (aged 0-17) with TB notified to the Ministry of Health between 1990 and 1999. Results: There were 479 children with TB (male/female ratio 1.36). Most cases (81.8%) were foreign born, predominantly (88.2%) immigrants from Ethiopia and, therefore, huge differences existed in TB incidence rates according to countries of origin. Some 80% were diagnosed within 3 years of arrival, mainly due to active case-finding. Pulmonary TB, with infiltrates on chest X-ray, was found in 49.5%. Extra-pulmonary TB sites were: intra-thoracic lymphadenitis (31.1%), extra-thoracic lymphadenitis (12.5%), bones (3.6%), pleura (1.3%), meninges (1%), and others (1%). Seventy percent had a tuberculin skin test reaction ≥10 mm in size. Two (non-immigrant) children died of TB meningitis. Conclusions: Most of the pediatric TB cases occurred in recent immigrants and were diagnosed within 3 years of immigration. These data support our policy of active case-finding among new immigrants from Ethiopia and extensive contact evaluation for all TB cases.

Author Keywords

Migration Outcome assessment Childhood tuberculosis Process assessment Israel Epidemiology

Index Keywords

extrapulmonary tuberculosis immigrant Israel mass screening human immigration geographic distribution Outcome and Process Assessment (Health Care) Humans Medical Records Adolescent Infant, Newborn male female tuberculosis Infant Child, Preschool time series analysis Incidence prevalence Article Retrospective Studies Ethiopia fatality major clinical study tuberculin test thorax radiography endemic disease Sex Distribution childhood disease age distribution Emigration and Immigration retrospective study Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-30944438095&partnerID=40&md5=9dbbe0d9d65e915031caf6a2640d86cc
ISSN: 15651088
Cited by: 13
Original Language: English