학술논문
Incidencia, prevalencia y riesgo anual de infección tuberculosa en niños de 6-7 años en la ciudad de Valencia. Aportación de las nuevas técnicas inmunodiagnósticas
Document Type
Dissertation/Thesis
Author
Source
TDX (Tesis Doctorals en Xarxa)
Subject
616.2
Language
Spanish; Castilian
Abstract
Objectives: To assess the prevalence of tuberculosis (TB) and the annual risk infection (AIR) in children 6‐7 years old in Valencia. To compare the performance of the QuantiFERON‐Gold–in tube (QFN‐G‐IT) with the TST in the school based screening, and to determine the effect of the previous nontuberculous mycobacteria (NTM) sensitization in the tuberculin skin test (TST) results. Material and Methods: During 2007‐08, TST were administered by the Mantoux method in children whose parents signed informed consent in the selected schools. Indurations ≥5 mm was considered positive and subsequent clinical and radiographics studies were performed. A detailed questionnaire was completed. QFN‐G‐IT was undertaken in positive children and also in a control group. Blood samples for TSPOT. TB and M. avium sensitin were collected in TST (+) / QFN‐G‐IT (‐) children. Results: 1,200 (70.9%) children in 2007 and 1077 (61.6%).in 2008 were studied. Thirtyone children obtained TST (+); 6 BCG reactors, 3 previous treated TB, 3 active TB and 19 LTBI. Prevalence of LTBI was 0.83 %, (IC 95%: 0.28‐1.39) AIR was 0.10% (95% CI: 0.019‐0.183). Univariate analysis revealed significant association between positive TST result and BCG vaccination, foreign origin (children or / and parents), father's age, level parents studies, and previous tuberculosis father's family. The QFN‐G‐IT was performed in 64 children: (31 with TST ≥5mm), 32 % of TST positive subjects had a positive QFT.G‐IT result. The overall agreement between two tests was poor. All TSPOT. TB tested children obtained a negative result. Six out of fifteen children were positive to the M.avium sensitin (2 TB and 4 LTBI) Conclusion: The prevalence of LTBI in children between 6‐7 years old is low. The QFNG‐ IT confirms only 32% of positive results in the PT, consistent with previous studies of screening in children (+) TST/ (‐) QFN‐G‐IT, NTM sensitization were detected by 40%, suggesting the importance of NTM infections in our area. Two‐step strategy (TST and, according to results / clinical situation, QFN‐G‐IT) is a recommended option in the screening of LTBI in the children.