Journal of Paediatrics and Child Health
Volume 55, Issue 7, 2019, Pages 826-832

Latent tuberculosis may be missed by current screening practices: Analysis of interferon-gamma release assay results from a paediatric refugee clinic (Article)

Colgan K.* , Anderson J. , Maycock A. , Britton P.N. , Mackenzie M. , Isaacs D. , Gunasekera H.
  • a Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia
  • b Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  • c Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia
  • d Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  • e Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia
  • f Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  • g Health Assessment for Refugee Kids Clinic, Priority Populations, Children's Hospital at Westmead, Sydney, NSW, Australia, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

Abstract

Aims: (i) To determine the prevalence of latent tuberculosis infection (LTBI) and characteristics associated with LTBI in children attending a paediatric refugee clinic and (ii) to determine whether current New South Wales (NSW) Health screening practices could miss LTBI cases. Methods: This was a retrospective analysis of tuberculosis (TB) screening data from refugee and asylum seeker children who attended a refugee clinic in a tertiary children's hospital during 2014 and 2015. We determined associations between LTBI and child characteristics at 5% significance levels. Results: Of 358 children attending the clinic, 235 children (66%) received interferon-gamma release assay (IGRA) testing, of whom 28 (11.9%) had positive results. Of the 28 with positive IGRAs, 12 (42.9%) would have been missed using NSW Health screening guidelines: two because they were younger than 2 years old, one who was born in Australia and 10 because they were not born in high TB incidence countries. IGRA results were not significantly associated with any of the child characteristics examined, including age, gender, travel through transit countries, boat versus plane arrival into Australia, whether the child had been in a detention centre or TB incidence in the source country. Conclusions: We identified 12 children with LTBI who would have been missed using current NSW Health Department screening practices. These children are at risk of progression to active disease, particularly the two aged younger than 2 years old. We recommend universal screening. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)

Author Keywords

Screening population health interferon-gamma release assay tuberculosis Refugee Latent tuberculosis infection

Index Keywords

patient transport human interferon gamma release assay priority journal screening test health care practice male latent tuberculosis preschool child female groups by age and sex tertiary care center refugee camp New South Wales prevalence Incidence Article major clinical study infection risk diagnostic error retrospective study Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058839726&doi=10.1111%2fjpc.14304&partnerID=40&md5=8eab78657ae90eddea9a6e98ae5e2214
DOI: 10.1111/jpc.14304
ISSN: 10344810
Original Language: English