Pediatric Infectious Disease Journal
Volume 29, Issue 7, 2010, Pages 648-651

Impact of immigration on pulmonary tuberculosis in Spanish children: A three-decade review (Article)

Del Rosal T.* , Baquero-Artigao F. , García-Miguel M.J. , Méndez-Echevarría A. , López G. , Aracil F.J. , De José M.I. , Del Castillo F.
  • a Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain
  • b Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain
  • c Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain
  • d Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain
  • e Microbiology Department, La Paz Hospital, Madrid, Spain
  • f Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain
  • g Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain
  • h Pediatric Infectious Diseases Unit, La Paz Hospital, Madrid, Spain

Abstract

Background: Tuberculosis causes significant morbidity and mortality worldwide. In the last years, international travel and immigration have led to important changes in the epidemiology of this disease. Drug resistance has emerged as an important threat to tuberculosis control. Data regarding the impact of immigration and the incidence of drug-resistant strains in children are lacking. Methods: Retrospective review of patients diagnosed with pulmonary tuberculosis at La Paz Children's Hospital in a 30-year period. Data were collected with regard to the clinical, radiologic, microbiologic, and demographic characteristics of patients, and data from the 3 decades of the study were compared using χ test and Fisher exact test. Results: A total of 507 cases of tuberculosis were identified, 414 of which had pulmonary involvement. During the study, there was a significant decrease in tuberculous meningitis: 10.4% in 1978-1987, 5.6% in 1988-1997, and 2.9% in 1998-2007 (P < 0.05). The most frequent reason for a consultation was case contact investigation. The adult source case was identified in 64% of patients. We observed an increase in extrafamilial contacts (8% in 1978-1987 and 18% in 1998-2007, P < 0.01), including 4 cases of immigrant caretakers. Tuberculosis in immigrant children has increased with time: 2% in the period 1978-1987, 6% in 1988-1997, and 46% in 1998-2007 (P < 0.001). The primary resistance rate to isoniazid in our population was 6.5%. Conclusions: Tuberculosis in our area continues to be a major health problem, especially among foreign-born children. As drug-resistant strains are increasing, initial therapy with 4 drugs is recommended in our population. © 2010 by Lippincott Williams & Wilkins.

Author Keywords

Drug-resistance Immigration tuberculosis

Index Keywords

medical record review extrapulmonary tuberculosis demography clinical feature human immigration priority journal pathology Tuberculosis, Meningeal tuberculous meningitis school child Humans lung tuberculosis tuberculostatic agent Antitubercular Agents Infant, Newborn Adolescent Tuberculosis, Pulmonary preschool child male Infant Child, Preschool newborn Spain female consultation contact examination Article Contact Tracing Retrospective Studies major clinical study migration isoniazid microbiology antibiotic resistance Emigration and Immigration retrospective study Drug Resistance, Bacterial Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77954348482&doi=10.1097%2fINF.0b013e3181d5da11&partnerID=40&md5=5949c7528e1f1c0308538ceda03eff47
DOI: 10.1097/INF.0b013e3181d5da11
ISSN: 08913668
Cited by: 21
Original Language: English