Determinants for Tuberculosis Infection Among Children Investigated with Interferon Gamma Release Assays and Having Contact with Adult Tuberculosis Cases
E. Critselis, N.P. Spyridis, M. Mavrikou, K. Benetatou, K. Karavanaki, C. Bakoula, M.N. Tsolia
31st Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2013)
Milan, Italy, May 28-June 1, 2013
BACKGROUND AND AIMS: The predictive factors of latent tuberculosis infection (LTBI) among children remain irresolute. The study evaluated the determinants associated with LTBI among children having contact with adult index cases.
METHODS: A cross-sectional study was conducted among 223 children (mean age±SD:7.8±4.7 years) evaluated for LTBI. Participants were assessed concomitantly with the tuberculin skin test and QuantiFERON-TB Gold-In-Tube (QFT-IT) assay. Children with indeterminate QFT-IT findings were excluded. LTBI was defined among children with positive QFT-IT.
RESULTS: Among the study sample (n=223), QFT-IT results were negative in 59.6% (n=133), positive in 37.7% (n=84), and indeterminate in 2.7% (n=6) children. Children with LTBI did not differ from their noninfected counterparts with respect to age (p=0.147), gender (p=0.850), or ethnicity (p=0.220). The proportion of adult cases among whom the laboratory isolation of M. tuberculosis was confirmed was similar between groups (p=0.320). LTBI children did not differ from their non-infected counterparts with respect to living conditions and/or socioeconomic indicators. Following controlling for confounding factors, the multivariate regression analysis indicated that LTBI was independently associated with lack of prior BCG immunization (adjusted odds ratio, AOR:4.17; 95% CI:1.33-12.55), patient age (AOR:1.23; 95% CI: 1.09-1.39), and origin from a TB endemic country (AOR:3.33; 95% CI:1.45-7.69).
CONCLUSIONS: Lack of prior BCG immunization was proximally associated with LTBI among children having contact with adult cases. Additional determinants included greater age and origin from a TB endemic country. Public health interventions aimed at deterring LTBI among children should account for the identified risk factors for TB infection.