Detection and Treatment of Tuberculosis Infection in Children in Brighton: A Service Evaluation

 
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Mahmoud Rashid*, K Fidler**
Brighton and Sussex Medical School, UK*, Brighton and Sussex Medical School, UK**
Abstract
Background
TB is the second biggest infectious killer worldwide after HIV. Infection is usually pulmonary, and can lead to active TB disease or latent TB infection (LTBI). The gold standard for diagnosing active TB is mycobacterial culture although this is more difficult in children than adults as they have paucibacillary disease and often don’t produce sputum. In addition, there is no gold standard diagnostic test for latent TB. to overcome such barriers, and because of increasing numbers of children with active and latent TB in 2009-2011, a TB detection and treatment service was established in 2011 at RACH. This project is the first evaluation of this service, with the aim of analysing who this service saw, how they were screened, the utility of diagnostic tests, and their outcome.

Methods
Children attending the TB service between 1st May 2011 and 1st April 2014 for the following reasons were included: known contacts of a TB case; suspected TB disease and new entrants from high-burden countries. Clinical notes were reviewed and anonymised demographic and clinical data were recorded.

Results and conclusions
178 children were seen by this service. 89 were contacts of an index case of TB, 57 were new entrants, 20 were suspected of having TB and 12 required a BCG but were required to rule of TB first. 8 children were diagnosed with active TB, 2 of whom were identified through contact screening. 6 children were diagnosed with LTBI, all of whom were identified through contact screening. This suggests a fall in TB cases in Brighton since 2011. Positive results were more likely in MST rather than IGRA, but IGRA positivity was more greatly associated with subsequent treatment for TB.
 
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Rashid M, Fidler K.. Available From : http://www.pediatriconcall.com/conference/abstract/33/view/825
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