Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016
Abstract BACKGROUND There is little detailed epidemiologic and clinical data about tuberculosis (TB) disease in children in Canada. OBJECTIVES This study characterizes the epidemiologic, clinical, and treatment data for all cases of TB in children under age 15 in Canada surveyed through the Canadian...
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Online Access: | http://dx.doi.org/10.1093/pch/pxy054.033 http://academic.oup.com/pch/article-pdf/23/suppl_1/e13/28940380/pxy054.033.pdf |
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croxfordunivpr:10.1093/pch/pxy054.033 2023-05-15T16:17:17+02:00 Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 Giroux, Ryan Montgomery-Song, Aaryn Consunji-Araneta, Raquel Kitai, Ian Morris, Shaun 2018 http://dx.doi.org/10.1093/pch/pxy054.033 http://academic.oup.com/pch/article-pdf/23/suppl_1/e13/28940380/pxy054.033.pdf en eng Oxford University Press (OUP) https://academic.oup.com/journals/pages/about_us/legal/notices Paediatrics & Child Health volume 23, issue suppl_1, page e13-e13 ISSN 1205-7088 1918-1485 Pediatrics, Perinatology and Child Health journal-article 2018 croxfordunivpr https://doi.org/10.1093/pch/pxy054.033 2022-04-15T06:18:08Z Abstract BACKGROUND There is little detailed epidemiologic and clinical data about tuberculosis (TB) disease in children in Canada. OBJECTIVES This study characterizes the epidemiologic, clinical, and treatment data for all cases of TB in children under age 15 in Canada surveyed through the Canadian Paediatric Surveillance Program’s (CPSP) Childhood Tuberculosis Study from October 2013 to September 2016. DESIGN/METHODS New active TB cases were identified through a monthly form sent by the CPSP to approximately 2500 active paediatricians, paediatric subspecialists, and select non-paediatricians who manage childhood TB. For cases meeting inclusion criteria, a detailed questionnaire was sent to the treating physician to collect clinical, epidemiological, and treatment data, followed by 6-month follow-up surveys until 6 months after treatment completion. Cases were reviewed by at least one TB specialist for inclusion and classification of disease. RESULTS Of 285 unique incident cases reported, 188 cases met inclusion criteria, returned a detailed questionnaire, and were classified. Selected demographic data are shown in Table 1. 92% of cases had intrathoracic involvement (N=172, 91%), but a minority were confirmed by culture or nucleic acid amplification (62/172, 36%). The most common sites of intrathoracic involvement were lymph nodes (N=118, 69%) and lungs (N=54, 31%). There were 143 attempted respiratory microbiological studies, with 32 (22%) yielding a positive culture or NAAT in sputum and 33 (23%) in gastric aspirate. Highest yield was in the 10+ age group with 54% (20/37) positivity. 31 cases of extrathoracic TB were recorded, with 19/35 (54%) having simultaneous intrathoracic TB. The most common forms of extrathoracic TB included CNS or meningeal disease (N=13) and extrathoracic lymphadenopathy (N=11). Miliary or disemminated disease (2 or more non-continguous sites involved) was found in 15 cases (8%). 16 cases reported at least one adverse drug reactions, with pyrazinamide (N=10) and isoniazid (N=5) being most common. 4 children were hospitalized and the most common ADR was hepatotoxicity. There was one case of multi-drug resistant TB. CONCLUSION This study suggests a high incidence of TB in Inuit and First Nations children, as well as a higher proportion of extrathoracic TB and greater success in culture positivity in children aged 10+. It also shows a significant number of adverse drug reactions to anti-TB treatment. Further analysis of this data will serve to refine practice in monitoring, detecting, and treating this infection. Article in Journal/Newspaper First Nations inuit Oxford University Press (via Crossref) Canada Paediatrics & Child Health 23 suppl_1 e13 e13 |
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Open Polar |
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Oxford University Press (via Crossref) |
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croxfordunivpr |
language |
English |
topic |
Pediatrics, Perinatology and Child Health |
spellingShingle |
Pediatrics, Perinatology and Child Health Giroux, Ryan Montgomery-Song, Aaryn Consunji-Araneta, Raquel Kitai, Ian Morris, Shaun Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 |
topic_facet |
Pediatrics, Perinatology and Child Health |
description |
Abstract BACKGROUND There is little detailed epidemiologic and clinical data about tuberculosis (TB) disease in children in Canada. OBJECTIVES This study characterizes the epidemiologic, clinical, and treatment data for all cases of TB in children under age 15 in Canada surveyed through the Canadian Paediatric Surveillance Program’s (CPSP) Childhood Tuberculosis Study from October 2013 to September 2016. DESIGN/METHODS New active TB cases were identified through a monthly form sent by the CPSP to approximately 2500 active paediatricians, paediatric subspecialists, and select non-paediatricians who manage childhood TB. For cases meeting inclusion criteria, a detailed questionnaire was sent to the treating physician to collect clinical, epidemiological, and treatment data, followed by 6-month follow-up surveys until 6 months after treatment completion. Cases were reviewed by at least one TB specialist for inclusion and classification of disease. RESULTS Of 285 unique incident cases reported, 188 cases met inclusion criteria, returned a detailed questionnaire, and were classified. Selected demographic data are shown in Table 1. 92% of cases had intrathoracic involvement (N=172, 91%), but a minority were confirmed by culture or nucleic acid amplification (62/172, 36%). The most common sites of intrathoracic involvement were lymph nodes (N=118, 69%) and lungs (N=54, 31%). There were 143 attempted respiratory microbiological studies, with 32 (22%) yielding a positive culture or NAAT in sputum and 33 (23%) in gastric aspirate. Highest yield was in the 10+ age group with 54% (20/37) positivity. 31 cases of extrathoracic TB were recorded, with 19/35 (54%) having simultaneous intrathoracic TB. The most common forms of extrathoracic TB included CNS or meningeal disease (N=13) and extrathoracic lymphadenopathy (N=11). Miliary or disemminated disease (2 or more non-continguous sites involved) was found in 15 cases (8%). 16 cases reported at least one adverse drug reactions, with pyrazinamide (N=10) and isoniazid (N=5) being most common. 4 children were hospitalized and the most common ADR was hepatotoxicity. There was one case of multi-drug resistant TB. CONCLUSION This study suggests a high incidence of TB in Inuit and First Nations children, as well as a higher proportion of extrathoracic TB and greater success in culture positivity in children aged 10+. It also shows a significant number of adverse drug reactions to anti-TB treatment. Further analysis of this data will serve to refine practice in monitoring, detecting, and treating this infection. |
format |
Article in Journal/Newspaper |
author |
Giroux, Ryan Montgomery-Song, Aaryn Consunji-Araneta, Raquel Kitai, Ian Morris, Shaun |
author_facet |
Giroux, Ryan Montgomery-Song, Aaryn Consunji-Araneta, Raquel Kitai, Ian Morris, Shaun |
author_sort |
Giroux, Ryan |
title |
Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 |
title_short |
Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 |
title_full |
Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 |
title_fullStr |
Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 |
title_full_unstemmed |
Final Results of National Surveillance of Childhood Tuberculosis in Canada: 2013–2016 |
title_sort |
final results of national surveillance of childhood tuberculosis in canada: 2013–2016 |
publisher |
Oxford University Press (OUP) |
publishDate |
2018 |
url |
http://dx.doi.org/10.1093/pch/pxy054.033 http://academic.oup.com/pch/article-pdf/23/suppl_1/e13/28940380/pxy054.033.pdf |
geographic |
Canada |
geographic_facet |
Canada |
genre |
First Nations inuit |
genre_facet |
First Nations inuit |
op_source |
Paediatrics & Child Health volume 23, issue suppl_1, page e13-e13 ISSN 1205-7088 1918-1485 |
op_rights |
https://academic.oup.com/journals/pages/about_us/legal/notices |
op_doi |
https://doi.org/10.1093/pch/pxy054.033 |
container_title |
Paediatrics & Child Health |
container_volume |
23 |
container_issue |
suppl_1 |
container_start_page |
e13 |
op_container_end_page |
e13 |
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1766003127541039104 |