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Godoy S, Parrón I, Millet JP, Caylà JA, Follia N, Carol M, Orcau A, Alsedà M, Toledo D, Plans P, Ferrús G, Barrabeig I, Clotet L, Domínguez A, Godoy P. Risk of tuberculosis among pulmonary tuberculosis contacts: the importance of time of exposure to index cases. Ann Epidemiol 2024; 91:12-17. [PMID: 38219967 DOI: 10.1016/j.annepidem.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Abstract
INTRODUCTION The intensity of exposure to index cases of tuberculosis [TB] may increase the risk of TB in their contacts. The aim was to determine TB risk factors among contacts of TB index cases. METHODS A cohort study was carried out in the contacts of pulmonary TB cases registered by the epidemiological surveillance network from 01/01/2019 to 06/30/2021. The factors associated with the risk of TB in contacts were determined using the adjusted odds ratio [aOR] and its 95% confidence interval [CI]. RESULTS From 847 TB cases, 7087 contacts were identified. The prevalence of TB was 2.0% [145/7087] and was higher in < 5 years compared to those ≥ 65 years [4.4% versus 1.2%; p < 0.001], in those exposed ≥ 6 h daily [4%], and < 6 h daily [1.6%] with respect to weekly exposure of < 6 h [0.7%; p < 0.001]. Those contacts exposed ≥ 6 h daily [aOR= 6.9; 95%CI:2.1-22.1], < 5 years [aOR= 8.3; 95%CI:1.8-37.8] and immigrants [aOR= 1.7; 95%CI:1.1-2.7] had a higher risk of TB. CONCLUSIONS The risk of TB increases with the time of exposure to the index case and this risk is also higher in < 5 years and immigrants. Contact tracing has a high yield for detecting new cases of TB.
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Affiliation(s)
- Sofia Godoy
- Universitat de Lleida [UdL]. Institut de Recerca Biomédica de Lleida [IRBLleida], Lleida, Spain; Institut Català de la Salut, Lleida, Spain
| | - Ignasi Parrón
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Joan-Pau Millet
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain; Barcelona Tuberculosis Research Unit Foundation, Barcelona, Spain; Epidemiology Service. Public Health Agency of Barcelona. Barcelona, Spain
| | - Joan A Caylà
- Barcelona Tuberculosis Research Unit Foundation, Barcelona, Spain
| | - Núria Follia
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Monica Carol
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Angels Orcau
- Epidemiology Service. Public Health Agency of Barcelona. Barcelona, Spain
| | - Miquel Alsedà
- Universitat de Lleida [UdL]. Institut de Recerca Biomédica de Lleida [IRBLleida], Lleida, Spain; Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Diana Toledo
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain; Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Pere Plans
- Agència de Salut Pública Catalunya, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain
| | - Gloria Ferrús
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Irene Barrabeig
- Agència de Salut Pública Catalunya, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain
| | - Laura Clotet
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Angela Domínguez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain; Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Pere Godoy
- Universitat de Lleida [UdL]. Institut de Recerca Biomédica de Lleida [IRBLleida], Lleida, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain; Hospital Universitari de Santa Maria, Lleida, Spain.
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2
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Gullón Blanco JA, Rodrigo Sanz T, Álvarez Navascues F, Tabernero Huguet E, Sabría Mestres J, García-García JM. Tuberculosis contacts study: Organization and prevalence of latent tuberculosis infection. Arch Bronconeumol 2021; 57:509-511. [PMID: 35698967 DOI: 10.1016/j.arbr.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/16/2020] [Indexed: 06/15/2023]
Affiliation(s)
- José Antonio Gullón Blanco
- Pneumology, University Hospital San Agustín, Avilés, Spain; Integrated Tuberculosis Research Program (PII-TB) SEPAR, Barcelona, Spain.
| | | | - Fernando Álvarez Navascues
- Pneumology, University Hospital San Agustín, Avilés, Spain; Integrated Tuberculosis Research Program (PII-TB) SEPAR, Barcelona, Spain
| | - Eva Tabernero Huguet
- Integrated Tuberculosis Research Program (PII-TB) SEPAR, Barcelona, Spain; Pneumology, University Hospital of Cruces, Baracaldo, Spain
| | - Josefina Sabría Mestres
- Integrated Tuberculosis Research Program (PII-TB) SEPAR, Barcelona, Spain; Pneumology, University Hospital Moisés Broggi, Sant Joan Despí, Spain
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3
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Millet JP. Basic characteristics for a good tuberculosis prevention and control programmes currently in Spain. ACTA ACUST UNITED AC 2021; 23:6-8. [PMID: 33847705 PMCID: PMC8278170 DOI: 10.18176/resp.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J P Millet
- Epidemiology Service. Public Health Agency of Barcelona. Barcelona.,Co-medical director at Serveis Clinics. Centro de Investigación Biomédica en Red (CIBER) of Epidemiology and Public Health. Barcelona
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Gullón Blanco JA, Rodrigo Sanz T, Álvarez Navascues F, Tabernero Huguet E, Sabría Mestres J, García-García JM. Tuberculosis Contacts Study: Organization and Prevalence of Latent Tuberculosis Infection. Arch Bronconeumol 2020; 57:S0300-2896(20)30562-7. [PMID: 33526297 DOI: 10.1016/j.arbres.2020.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Affiliation(s)
- José Antonio Gullón Blanco
- Unidad de Gestión Clínica Neumología, Hospital Universitario San Agustín, Avilés, España; Programa Integrado de Investigación en Tuberculosis (PII-TB) SEPAR, Barcelona, España.
| | - Teresa Rodrigo Sanz
- Programa Integrado de Investigación en Tuberculosis (PII-TB) SEPAR, Barcelona, España
| | - Fernando Álvarez Navascues
- Unidad de Gestión Clínica Neumología, Hospital Universitario San Agustín, Avilés, España; Programa Integrado de Investigación en Tuberculosis (PII-TB) SEPAR, Barcelona, España
| | - Eva Tabernero Huguet
- Programa Integrado de Investigación en Tuberculosis (PII-TB) SEPAR, Barcelona, España; Servicio de Neumología, Hospital Universitario de Cruces Baracaldo, España
| | - Josefina Sabría Mestres
- Programa Integrado de Investigación en Tuberculosis (PII-TB) SEPAR, Barcelona, España; Servicio de Neumología, Hospital Universitario Moisés Broggi, Sant Joan Despí, España
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5
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Threats and Interventions During the Treatment of Tuberculosis in an Inner-city District. Arch Bronconeumol 2020; 57:330-337. [PMID: 32593536 DOI: 10.1016/j.arbres.2020.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Since there are active drugs against tuberculosis (TB), the most effective control measures are to assure treatment adherence and to perform contact tracing. Given the long treatment duration and characteristics of some TB patients, threats that put at risk treatment adherence may appear. Identify and address them is essential to achieve the objectives of disease control. OBJECTIVES To identify the epidemiological characteristics of TB patients and the incidents and threats occurring during treatment, to describe the interventions performed to enhance treatment adherence and to determine if there are differences among native and foreign-born patients in the TB clinical unit of a referral hospital in the inner city of Barcelona. METHODS A descriptive, observational, cross-sectional study was performed. We recorded information on sociodemographic and clinical characteristics, incidents and interventions during treatment in all patients with TB diagnosed between September 2013 and August 2016. RESULTS 172 patients were included, 62.2% were foreign-born. The most common incidents and threats were medication-related complications (43.0%), missed follow-up visits (34.3%), communication problems (25.6%), comorbidities complications (23.8%), trips (19.2%), fear of social rejection (16.9%) and change of address (14.5%). The adherence-promoting interventions were: follow-up calls, directly observed treatment, medical and humanitarian reports, extra visits and cultural mediation. Incidents and interventions were more frequent in foreign-born patients, however there were no differences in treatment success among Spanish and foreign-born. CONCLUSION In this inner city several incidents occurred during TB treatment that can threaten adherence and are more common among foreign-born patients. Coordination among professionals from different healthcare settings was able to overcome obstacles in most cases and achieve TB treatment completion.
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Bellmunt JM, Caylà JA, Millet JP. [Contact tracing in patients infected with SARS-CoV-2. The fundamental role of Primary Health Care and Public Health]. Semergen 2020; 46 Suppl 1:55-64. [PMID: 32571677 PMCID: PMC7274580 DOI: 10.1016/j.semerg.2020.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022]
Abstract
Con el objetivo de favorecer la rápida identificación de los contactos de pacientes infectados por SARS-CoV-2 y por tanto el control de la pandemia, se revisaron diferentes metodologías y recomendaciones sobre estudio de contactos (EECC) aplicables a la Atención Primaria (AP) y a la Salud Pública (SP): artículos en Pubmed sobre COVID-19 y EECC, definiciones de contacto en documentos oficiales, el sistema clásico de EECC en tuberculosis (TB), informaciones sobre apps para EECC y el papel de las pruebas diagnósticas. Para establecer medidas de prevención y control eficientes, se precisa actuar siempre bajo sospecha clínica, diagnóstico y aislamiento precoz de los casos y de los contactos y su seguimiento. El modelo clásico de EECC en TB es aplicable a esta nueva infección pero acelerando el proceso dado su carácter agudo y su potencial gravedad. Es imprescindible una buena coordinación entre AP y SP y disponer de recursos suficientes.
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Affiliation(s)
- J M Bellmunt
- ABS Barceloneta, Parc Sanitari Pere Virgili. Departament de Medicina, Universitat Autònoma de Barcelona. Unidad de Investigación en Tuberculosis de Barcelona, Barcelona, España
| | - J A Caylà
- Fundación de la Unidad de Investigación en Tuberculosis de Barcelona, Barcelona, España.
| | - J P Millet
- Servicio de Epidemiología, Agència de Salut Pública de Barcelona. Serveis Clínics, Barcelona. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, España
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7
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Godoy P, Alsedà M. Vigilancia de los contactos en la tuberculosis: ¿cómo podemos mejorar la estrategia? Enferm Infecc Microbiol Clin 2019; 37:493-495. [DOI: 10.1016/j.eimc.2019.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 10/25/2022]
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Organization of Tuberculosis Control in Spain: Evaluation of a Strategy Aimed at Promoting the Accreditation of Tuberculosis Units. Arch Bronconeumol 2019; 56:90-98. [PMID: 31171411 DOI: 10.1016/j.arbres.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/03/2019] [Accepted: 04/26/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Well-coordinated multidisciplinary teams are essential for better tuberculosis (TB) control. Our objective was to evaluate the impact of Spanish Society of Pneumology (SEPAR) accreditation of TB Units (TBU) and to determine differences between the accredited and non-accredited centers. MATERIAL AND METHODS DESIGN Observational descriptive study based on a self-administered survey from October 2014 to February 2018 completed by 139 heads of respiratory medicine departments collected by SEPAR, before and after TBU accreditation. VARIABLES demographic, epidemiological and contact tracing (CT) variables, among others. ANALYSIS basic descriptive analysis, and calculation of medians for continuous variables and proportions for categorical variables. The variables were compared using the Chi-squared test and logistic regression. RESULTS The response rate was 54.7% and 43.2% in the pre- and post-TBU accreditation period, respectively. No differences were observed in the care and coordination variables between the pre- and post-accreditation survey, nor in the organization when only accredited centers were analyzed. When we compared the accredited and non-accredited centers, significant differences were detected in the collection of the final conclusion, management of resistance, coordination with other departments, contact tracing, and directly observed treatment. CONCLUSIONS The approach of different professionals with regard to TB has been addressed. Positive aspects and areas for improvement have been detected, and better results were observed in the accredited versus non-accredited centers. A closer supervision of TBUs is necessary to improve their effectiveness.
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Martin-Sanchez M, Brugueras S, de Andrés A, Simon P, Gorrindo P, Ros M, Masdeu E, Millet JP, Caylà JA, Orcau À. Tuberculosis incidence among infected contacts detected through contact tracing of smear-positive patients. PLoS One 2019; 14:e0215322. [PMID: 30986227 PMCID: PMC6464217 DOI: 10.1371/journal.pone.0215322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/29/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The contacts of people with pulmonary tuberculosis (PTB) have a high risk of becoming infected and developing tuberculosis (TB). Our aim was to determine the incidence of TB and its risk factors in a cohort of contacts with latent TB infection (LTBI) detected through contact tracing of smear-positive PTB cases. METHODS AND FINDINGS We performed a population-based retrospective cohort study including contacts that had LTBI, and were contacts of people with PTB who started treatment between 2008 and 2014. We followed up contacts until they developed TB or until the end date for follow-up (31st December 2016). We used Kaplan-Meier curves to compute incidence at 2 and 5 years, and Cox regression to compute hazard ratios (HR) and their 95% confidence intervals (CI). We analyzed 3097 close contacts of 565 PTB cases. After exclusion of 81 co-prevalent TB cases, 953 contacts had LTBI, of which 14 developed TB. Their risk of developing TB after two and five years was 0.7% (CI: 0.3-1.6) and 1.8% (CI: 1.1-3.1) respectively. Contacts who had not been referred for LTBI treatment had a 1.0% (CI: 0.2-4.0) risk at 5 years. Risk of developing TB at 5 years was 1.2% (CI: 0.5-3.0) among people who completed treatment, and 11.1% (CI: 5.1-23.3) for those who did not. Risk factors for TB were not completing LTBI treatment (HR 9.4, CI: 2.9-30.8) and being female (HR 3.5, CI: 1.1-11-3). CONCLUSIONS LTBI treatment plays a fundamental role in decreasing the risk of developing TB. It is necessary to achieve a maximum contact tracing coverage and the highest possible compliance with LTBI treatment.
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Affiliation(s)
- Mario Martin-Sanchez
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Preventive Medicine and Public Health Training Unit Parc de Salut Mar–Pompeu Fabra University—Agència de Salut Pública de Barcelona (PSMar-UPF-ASPB), Barcelona, Spain
| | - Silvia Brugueras
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- The Biomedical Research Center Network of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna de Andrés
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Pere Simon
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Pilar Gorrindo
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Miriam Ros
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Eva Masdeu
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Joan-Pau Millet
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- The Biomedical Research Center Network of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Joan A. Caylà
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Àngels Orcau
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- The Biomedical Research Center Network of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
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10
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Barss L, Menzies D. Using a quality improvement approach to improve care for latent tuberculosis infection. Expert Rev Anti Infect Ther 2019; 16:737-747. [PMID: 30318977 DOI: 10.1080/14787210.2018.1521269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Latent tuberculosis infection (LTBI) management is recognized as a key component of the World Health Organization End Tuberculosis Strategy. The term 'cascade of care in LTBI' has recently been used to refer to the process of LTBI management from identification of persons who may have LTBI to completion of treatment. Large gaps throughout the LTBI cascade of care have been identified. Areas covered: We have reviewed quality improvement (QI) as a potential approach for systematically improving gaps within the LTBI cascade of care. QI principles and approaches were reviewed, as well as the determinants of losses and evidence for solutions (interventions) within the LTBI cascade of care. An example of QI application in LTBI management is described. Expert commentary: Improving LTBI care at the magnitude required to reach the End TB Strategy goals will require systematic and context specific improvements at all steps in the cascade of care in LTBI. A continuous QI approach based on systems thinking, use of locally gathered data, and an iterative learning process can facilitate the process required to make the necessary improvements.
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Affiliation(s)
- Leila Barss
- a Montreal Chest Institute , McGill University , Montreal , QC , Canada
| | - Dick Menzies
- a Montreal Chest Institute , McGill University , Montreal , QC , Canada
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Soriano-Arandes A, Brugueras S, Rodríguez Chitiva A, Noguera-Julian A, Orcau À, Martín-Nalda A, Millet JP, Vallmanya T, Méndez M, Coll-Sibina M, Mayol L, Clopés A, Pineda V, García L, López N, Calavia O, Rius N, Pérez-Porcuna TM, Soler-Palacín P, Caylà JA. Clinical Presentations and Outcomes Related to Tuberculosis in Children Younger Than 2 Years of Age in Catalonia. Front Pediatr 2019; 7:238. [PMID: 31245340 PMCID: PMC6579838 DOI: 10.3389/fped.2019.00238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/24/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Children younger than 2 years have an increased risk of complications associated with tuberculosis (TB) due to the immaturity of the innate and adaptive immune response. We aimed to identify TB clinical presentations and outcomes as well as risk factors for complications in this age group. Materials and Methods: Multicenter, retrospective, cross-sectional study of TB cases in children aged <2 years in Catalonia (2005-2013). Epidemiological and clinical data were collected from the hospital medical records. TB complications, sequelae included, were defined as any tissue damage generating functional or anatomical impairment after being diagnosed or after TB treatment being completed. Statistical analyses were based on bivariate chi-square and multivariate logistic regression, and it was carried out with Stata® version 13.1. Odds ratios (OR) and its 95% confidence intervals were calculated (CI). Results: A total of 134 patients were included, 50.7% were male, the median [IQR] age was 13[8-18] months, and 18.7% (25/134) showed TB-associated complications. Pulmonary TB was diagnosed in 94.0% (126/134) of children, and the most common complications were lobar collapse (6/126). TB meningitis was diagnosed in 14/134 (10.4%), and hydrocephalus and mental impairment occurred in 1 and 2 patients, respectively. Two patients with spinal TB developed vertebral destruction and paraplegia, respectively. Only one of the patients died. At multivariate level, tachypnea (OR = 4.24; 95% CI 1.17-15.35) and meningeal (OR = 52.21; 95% CI 10.05-271.2) or combined/extrapulmonary forms (OR = 11.3; 95% CI 2.85-45.1) were associated with the development of TB complications. Discussion: TB complications are common in children under 2 years old. Extrapulmonary TB forms in this pediatric age remain a challenge and require prompt diagnosis and treatment in order to prevent them. The presence of tachypnea at the time of TB diagnosis is an independent associated factor to the development of TB complications in infants. This clinical sign should be closely monitored in patients in this age group. It is necessary to perform further studies in this age group in a prospective design in order to understand whether there are other factors associated to TB complications.
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Affiliation(s)
- Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Silvia Brugueras
- Servei Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.,Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Barcelona, Spain.,Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alejandro Rodríguez Chitiva
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antoni Noguera-Julian
- Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Barcelona, Spain.,Hospital Universitari Sant Joan de Déu, Pediatrics, Esplugues de Llobregat, Spain.,Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain.,Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Àngels Orcau
- Servei Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.,Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Barcelona, Spain
| | - Andrea Martín-Nalda
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Joan P Millet
- Servei Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.,Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Barcelona, Spain
| | - Teresa Vallmanya
- Pediatrics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Maria Méndez
- Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Luis Mayol
- Pediatrics, Hospital Universitari Josep Trueta, Girona, Spain
| | | | - Valentí Pineda
- Pediatrics, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Lourdes García
- Pediatrics, Consorci Sanitari del Maresme, Mataró, Spain
| | - Nuria López
- Pediatrics, Hospital Universitari del Mar, Barcelona, Spain
| | - Olga Calavia
- Pediatrics, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Neus Rius
- Pediatrics, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Tomas M Pérez-Porcuna
- Unitat clínica de Tuberculosi i Salut Internacional, Fundació Recerca Mútua Terrassa, Servei de Pediatria, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Joan A Caylà
- Foundation of TB Research Unit of Barcelona, Barcelona, Spain
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Caylà JA, Caminero JA. The Historical Need for a National Tuberculosis Program for Spain. Arch Bronconeumol 2018; 54:603-604. [PMID: 30049559 DOI: 10.1016/j.arbres.2018.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Joan A Caylà
- Fundación de la Unidad de Investigación en Tuberculosis de Barcelona, Barcelona, España.
| | - José A Caminero
- Servicio de Neumología, Hospital General de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España; Unión Internacional contra la Tuberculosis y Enfermedades Respiratorias (La Unión), París, Francia
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