Risk of developing active TB in children with latent TB infection

Natalia Korneva1, Anna Starshinova1, Semen Ananiev1, Yulia Ovchinnikova1, Irina Dovgaluk1 and Piotr Yablonskii1,2
1Phthisiopulmonology Department, St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russian Federation, 2Department of Medicine, St. Petersburg State University, Saint-Petersburg, Russian Federation

Introduction or background: Effective treatment of latent tuberculosis infection (LTBI) is an important component in the fight against tuberculosis in children.

Objectives: The aim of this study is determine the effectiveness of preventive treatment of latent tuberculosis infection in children.

Materials and Methods: 209 children from 3 to 14 years old with positive results of tuberculin skin test were examined during 2013-2014 at children's phthisiopulmonology department (St.-Petersburg Institute of Phthisiopulmonology). Diagnostic complex included: QuantiFERON®-TB Gold (QFT), Diaskintest ® ( DST ) and computed tomography (CT). After examination in 80 children LTBI was diagnosed, in 54 children - tuberculosis, 75 children were confirmed as healthy . Patients with LTBI (80) were followed for 12 months. All LTBI children were divided in two groups: I group – 32 children (37.3%) who received preventive therapy (two anti-tuberculosis drugs for 3 months: isoniazid at dose of 10 mg / kg and pyrazinamide at dose of 25 mg / kg). II group – 48 children (62.7%) who did not get preventive therapy because their parents refused.

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Results: After control examination in 12 month 52 children (65%) developed tuberculosis and 28 children (35%) have the same status – LTBI. When comparing the incidence of active tuberculosis in children found that those who received preventive therapy, became ill in 59.4% (19) of cases, and children who didn't receive– in 68.8% (33), which is not statistically significant (p> 0,1).

Conclusions: Risk of developing TB in children with LTBI is quite high (65%). Carrying out preventive therapy for children with LTBI for 3 months has not significantly reduced the number of cases of tuberculosis.

Sumber : http://erj.ersjournals.com/content/46/suppl_59/PA2976