Archives of Disease in Childhood
Volume 90, Issue 11, 2005, Pages 1157-1161

Tuberculosis in New Zealand, 1992-2001: A resurgence (Review) (Open Access)

Howie S.* , Voss L. , Baker M. , Calder L. , Grimwood K. , Byrnes C.
  • a Medical Research Council Laboratories, PO Box 273, Banjul, Gambia, Division of Paediatrics, University of Auckland, Auckland, New Zealand
  • b Starship Children's Health, Auckland, New Zealand
  • c Institute of Environmental Science and Research, Porirua, New Zealand, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
  • d Public Health, Auckland District Health Board, Auckland, New Zealand
  • e Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
  • f Medical Research Council Laboratories, PO Box 273, Banjul, Gambia, Division of Paediatrics, University of Auckland, Auckland, New Zealand

Abstract

Objective: To describe the recent epidemiology and clinical features of paediatric tuberculosis (TB) in New Zealand (NZ). Methods: A retrospective review was conducted of clinical, laboratory, and radiology records of children <16 years old diagnosed with TB between January 1992 and June 2001 in nine NZ health districts. Results: A total of 274 patients <16 years old were identified; the average annual TB rate was 4.8 per 100 000. Rates rose over time reaching a peak of 10.1 in 1999. Rates were highest in under-5 year olds, at 6.2 per 100 000, and varied by ethnicity: African 575.2, Pacific Island 15.2, Maori 6.4, Asian 5.6, and European 0.6. Seventy two cases (26%) were foreign born. Thirty six per cent of cases were not detected until they presented with symptoms and of these 44% had no known TB contact. Most cases were identified by contact tracing (48%) or immigrant screening (11%); 43% were part of outbreaks. Miliary TB or meningitis occurred in 8% of patients, two of whom died. Drug resistance was found in 7% of culture positive cases and no HIV co-infection was found. Conclusions: A resurgence of TB occurred among children in NZ between 1992 and 2001 predominantly involving non-European and immigrant groups. Despite established contact tracing and immigrant screening programmes, many cases were part of outbreaks, remained unidentified until symptoms arose, or had no known TB contact. These findings point to an unrecognised burden of adult disease, ongoing community transmission, and missed opportunities for prevention. Further study is required to confirm these hypotheses.

Author Keywords

[No Keywords available]

Index Keywords

immigrant Human immunodeficiency virus infection poverty clinical feature human priority journal tuberculous meningitis ethnology Humans Adolescent Infant, Newborn male Tuberculosis, Pulmonary female Socioeconomic Factors tuberculosis Infant Child, Preschool Review symptom Incidence Disease Outbreaks epidemic disease transmission Retrospective Studies major clinical study New Zealand age distribution antibiotic resistance Emigration and Immigration retrospective study Drug Resistance, Bacterial miliary tuberculosis Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-27644440285&doi=10.1136%2fadc.2004.066415&partnerID=40&md5=3e80201c0279f64fe32b3a791b66022d
DOI: 10.1136/adc.2004.066415
ISSN: 00039888
Cited by: 23
Original Language: English