Pediatric Infectious Disease Journal
Volume 28, Issue 9, 2009, Pages 782-786

Risk factors for intrathoracic tuberculosis in children from economic migrant populations of two dominican republic bateyes (Article)

Cohn K.A. , Finalle R. , O'Hare G. , Feris J.M. , Fernández J. , Shah S.S.
  • a Alliance for International Medicine, United States, Division of General Pediatrics, United States
  • b Alliance for International Medicine, United States, Department of Primary Care Children's Hospital of Philadelphia, Philadelphia, PA, United States, Departamento de Enfermedades Infecciosas, Clinica Infantil, Robert Reid Cabral, Santo Domingo, Dominican Republic
  • c Alliance for International Medicine, United States, Department of Primary Care Children's Hospital of Philadelphia, Philadelphia, PA, United States
  • d Departamento de Enfermedades Infecciosas, Clinica Infantil, Robert Reid Cabral, Santo Domingo, Dominican Republic
  • e Departamento de Enfermedades Infecciosas, Clinica Infantil, Robert Reid Cabral, Santo Domingo, Dominican Republic
  • f Alliance for International Medicine, United States, Division of General Pediatrics, United States, Division of Infectious Diseases, Children's Hospital of Philadelphia, North Campus, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States, Departments of Pediatrics, United States, Departments of Epidemiology, United States, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, United States

Abstract

Objective: The objective of the current study was to identify risk factors for intrathoracic tuberculosis among children living in migrant populations in the Dominican Republic. Design: Cross-sectional study. Setting: Dominican Republic bateyes, economic migrant communities of Haitian origin. Participants: Children 18 months to 18 years of age. MAIN EXPOSURE: Unpasteurized milk consumption. OUTCOME MEASURES: Probable or possible intrathoracic tuberculosis. Probable intrathoracic tuberculosis was defined as any child with a tuberculin skin test-10 mm (or >5 mm in the presence of a known immunocompromising condition or household contact with intrathoracic tuberculosis) or malnutrition in the setting of an abnormal chest radiograph with features of tuberculosis or lymph node disease. The diagnosis of "possible intrathoracic tuberculosis" was assigned if an abnormal chest radiograph had features that did not meet the definition of "probable intrathoracic tuberculosis." Results: Probable or possible tuberculosis was diagnosed in 83 (20.8%) of 400 children. Unpasteurized milk consumption was identified as an independent risk factor for intrathoracic tuberculosis (adjusted odds ratio, 3.2; 95% confidence interval: 1.4-7.4) even after adjusting for Bacille Calmette-Guérin vaccination, household size, tuberculosis contacts and age and under varying assumptions about children diagnosed with "possible" tuberculosis. Conclusions: Our data raise the possibility that the high prevalence of tuberculosis in the Dominican Republic bateyes may be attributable to Mycobacterium bovis rather than Mycobacterium tuberculosis infection. Copyright © 2009 by Lippincott Williams and Wilkins.

Author Keywords

Transients and migrants Access to healthcare tuberculosis child Mycobacterium tuberculosis Dominican Republic Mycobacterium bovis Epidemiology

Index Keywords

food contamination household cervical lymph node clinical feature human immunocompromised patient Mycobacterium tuberculosis priority journal BCG vaccine milk Dominican Republic tuberculous lymphadenitis school child male female tuberculosis risk factor BCG vaccination prevalence Article major clinical study tuberculin test migration infection risk thorax radiography mycobacterium bovis intrathoracic tuberculosis outcome assessment malnutrition tuberculin Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-70249108519&doi=10.1097%2fINF.0b013e3181a164a8&partnerID=40&md5=d5a9dafcfaf7a288775f9aa22b306e60
DOI: 10.1097/INF.0b013e3181a164a8
ISSN: 08913668
Cited by: 4
Original Language: English