Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
European Journal of Pediatrics
Published in: European Journal of Pediatrics 8/2008

01-08-2008 | Original Paper

Proposed management of childhood tuberculosis in low-incidence countries

Authors: Klaus Magdorf, Anne K. Detjen

Published in: European Journal of Pediatrics | Issue 8/2008

Login to get access

Abstract

The incidence of childhood tuberculosis continues to decline in central Europe, but due to migration from high incidence countries paediatricians will still be confronted with it. The management of childhood tuberculosis in low-incidence, high-income countries differs from most high-incidence countries. The primary measures for preventing the transmission of tuberculosis to children are the detection of adult source cases, detection of latent TB infection (LTBI) in children by history, tuberculin skin testing and, if necessary and recommended, interferon-γ release assays. Children with LTBI should receive preventive therapy. The inclusion of tuberculosis in the differential diagnosis of unclear pulmonary and extrapulmonary disease remains important, and tuberculosis has to be managed according to international standards.
Literature
1.
Aaron L, Saadoun D, Calatroni I, Launay O, Mémain N, Vincent V, Marchal G, Dupont B, Bouchaud O, Valeyre D, Lortholary O (2004) Tuberculosis in HIV-infected patients: a comprehensive review. Clin Microbiol Infect 10:388–398PubMedCrossRef
2.
Algood HM, Lin PL, Flynn JL (2005) Tumor necrosis factor and chemokine interactions in the formation and maintenance of granulomas in tuberculosis. Clin Infect Dis 41(Suppl 3):S189–S193PubMedCrossRef
3.
Alzeer AH, FitzGerald JM (1993) Corticosteroids and tuberculosis: risks and use as adjunct therapy. Tubercle Lung Dis 74:6–11CrossRef
4.
American Thoracic Society/Centers for Disease Control and Prevention/Infectious Disease Society of America (2003) Treatment of tuberculosis. Am J Resp Crit Care Med 167:63–662
5.
American Thoracic Society, Centers for Disease Control and Prevention (2000) Targeted tuberculin testing, and treatment of latent tuberculosis infection. Am J Respir Crit Care Med 161:221–247
6.
Andersen P, Doherty TM, Pai M, Weldingh K (2007) The prognosis of latent tuberculosis: can disease be predicted? Trends Mol Med 13:175–182PubMedCrossRef
7.
Bartmann K, Massmann W (1961) Die Blutspiegel des INH bei Erwachsenen und Kindern. Beitr Klin Tuberk 124:310–319CrossRef
8.
Beglinger C, Dudler J, Mottet C, Nicod L, Seibold F, Villiger PM, Zellweger JP (2007) Screening for tuberculosis infection before initiation of anti-TNF-a therapy. Swiss Med Wkly 137:621–622
9.
10.
11.
Broekmans JF, Migliori GB, Rieder HL, Lees J, Ruutu P, Loddenkemper R, Raviglione MC (2002) European framework for tuberculosis control and elimination in countries with a low incidence. Eur Respir J 19:765–775PubMedCrossRef
12.
Canadian Tuberculosis Committee (2007) Interferon gamma release assays for latent tuberculosis infection. Canada Communicable Disease Report 2007, vol 33. Public Health Agency of Canada
13.
Casanova J-L, Abel L (2004) The human model: a genetic dissection of immunity to infection in natural conditions. Nat Rev Immunol 4:55–66PubMedCrossRef
14.
Centers for Disease Control and Prevention (CDC) (2005) Human tuberculosis caused by mycobacterium bovis - New York City, 2001–2004. MMWR 54:605–608
15.
Centers for Disease Control and Prevention (1992) Management of persons exposed to multidrug-resistant tuberculosis. MMWR 41:61–71
16.
Chintu C (2007) Tuberculosis and human immunodeficiency virus co-infection in children: management challenges. Paediatr Respir Rev 8:142–147PubMedCrossRef
17.
Colditz GA, Berkey CS, Mosteller F, Brewer TF, Wilson ME, Burdick E, Fineberg HV (1995) The efficacy of bacillus Calmette-Guérin vaccination of newborns and infants in the prevention of tuberculosis: meta-analyses of the published literature. Pediatrics 96:29–35PubMed
18.
Comstock GW, Caras GJ, Koplan JP (1999) How much isoniazid is needed for prevention of tuberculosis among immunocompetent adults? Int J Tuberc Lung Dis 3:847–850PubMed
19.
Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (2001) Richtlinien zur medikamentösen Behandlung der Tuberkulose im Erwachsenen- und Kindesalter. Pneumologie 55:494–511CrossRef
20.
Detjen AK, Keil T, Roll S, Hauer B, Mauch H, Wahn U, Magdorf K (2007) Interferon-γ release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis. Clin Infect Dis 45:322–328PubMedCrossRef
21.
Diel R, Nienhaus A, Lange C, Schaberg T (2006) Cost-optimization of screening for latent tuberculosis in close contacts. Eur Respir J 28:35–44PubMedCrossRef
22.
Diel R, Forssbohm M, Loytved G, Haas W, Hauer B, Maffei D, Magdorf K, Nienhaus A, Rieder HL, Schaberg T, Zellweger JP, Loddenkemper R (2007) Recommendations for background studies in tuberculosis. Pneumologie 61:440–455PubMedCrossRef
23.
Doherty TM, Demissie A, Menzies D, Andersen P, Rook G, Zumla A, VACSEL Study Group (2005) Effect of sample handling on analysis of cytokine responses to Mycobacterium tuberculosis in clinical samples using ELISA, ELISPOT and quantitative PCR. J Immunol Meth 298:129–141CrossRef
24.
Donald PR, Schaaf HS (2007) Old and new drugs for the treatment of tuberculosis in children. Paediatr Respir Rev 8:134–141PubMedCrossRef
25.
Dooley KE, Sterling TR (2005) Treatment of latent tuberculosis infection: challenges and prospects. Clin Chest Med 26:313–326PubMedCrossRef
26.
27.
Ena J, Valls V (2005) Short-course therapy with rifampin plus isoniazid, compared with standard therapy with isoniazid, for latent tuberculosis infection: a meta-analysis. Clin Infect Dis 40:670–676PubMedCrossRef
28.
Falzon D, Ait-Belghiti F (2007) What is tuberculosis surveillance in the European Union telling us? Clin Infect Dis 44:1268–1270CrossRef
29.
30.
Goletti D, Parracino MP, Butera O, Bizzoni F, Casetti R, Dainotto D, Anzidei G, Nisii C, Ippolito G, Poccia F, Girardi E (2007) Isoniazid prophylaxis differently modulates T-cell responses to RD1-epitopes in contacts recently exposed to Mycobacterium tuberculosis: a pilot study. Respir Res 8:5PubMedCrossRef
31.
Haimi-Cohen Y (2001) Skin indurations in response to tuberculin testing in patients with nontuberculous mycobacterial lymphadenitis. Clin Infect Dis 33:1786–1788PubMedCrossRef
32.
Haute Autorité de Santé (2006) Test de détéction de la production d’interferon-g pour le diagnosis des infection tuberculeuses. http://​www.​has-sante.​fr. Accessed 10 April 2008
33.
Haverkamp MH, Arend SM, Lindeboom JA, Hartwig NG, van Dissel JT (2004) Nontuberculous mycobacterial infection in children: a 2-year prospective surveillance study in the Netherlands. Clin Infect Dis 39:450–456PubMedCrossRef
34.
Huebner RE, Schein MF, Bass JB Jr (1993) The tuberculin skin test. Clin Infect Dis 17:968–975PubMed
35.
Idriss ZH, Sinno AA, Kronfol NM (1976) Tuberculous meningitis in childhood. Forty-three cases. Am J Dis Child 130:364–367
36.
Infuso A, Falzon D; on behalf of the EuroTB network (2006) European survey of BCG vaccination policies and surveillance in children. Euro Surveill 11:6–11PubMed
37.
38.
Jacobsen M, Detjen A, Mueller H, Gutschmidt A, Leitner S, Wahn U, Magdorf K, Kaufmann SH (2007) Clonal expansion of CD8 + effector T cells in childhood tuberculosis. J Immunol 179:1331–1339PubMed
39.
Joint Tuberculosis Committee of the British Thoracis Society (1998) Chemotherapy and management of tuberculosis in the United Kingdom. Thorax 53:536–548CrossRef
40.
Kauschke K, Magdorf K, Wahn U (1998) Mykobakteriell bedingte Lymphadenitis bei Kindern in Berlin 1981–1996. Monatsschr Kinderheilk Suppl 2:S159
41.
42.
Lawn SD, Bangani N, Vogt M, Bekker LG, Badri M, Ntobongwana M, Dockrell HM, Wilkinson RJ, Wood R (2007) Utility of interferon-gamma ELISPOT assay responses in highly tuberculosis-exposed patients with advanced HIV infection in South Africa. BMC Infect Dis 7:99PubMedCrossRef
43.
Liebeschuetz S, Bamber S, Ewer K, Deeks J, Pathan AA, Lalvani A (2004) Diagnosis of tuberculosis in South African children with a T-cell-bases assay: a prospective cohort study. Lancet 365:97–98
44.
Lobato MN, Hopewell PC (2000) Mycobacterium tuberculosis infection after travel to or contact with visitors from countries with a high prevalence of tuberculosis. Am J Respir Crit Care Med 158:1871–1875
45.
Loddenkemper R (2005) Aktuelle Information des DZK zur Tuberkulinversorgung Deutschlands. Pneumologie 59:236–237PubMedCrossRef
46.
47.
Magdorf K (2006) Tuberkulose im Kindesalter—Pathogenese, Prävention, Klinik und Therapie. Monatsschr Kinderheilk 154:124–132CrossRef
48.
Magdorf K (2003) Tuberkulose und nicht-tuberkulöse mykobakterielle Krankheiten. In: Handbuch, Infektionen bei Kindern und Jugendlichen, 4th edn. Futuramed, Munich, pp 699–719
49.
Magdorf K, Ertel M, Wahn U (1997) Tuberkulose im Kindesalter 2. Tuberkuloseformen, Symptomatik und Therapie. Pädiatr Prax 52:299–309
50.
Mandalakas AM, Starke JR (2005) Current concepts of childhood tuberculosis. Semin Pediatr Infect Dis 6:93–104CrossRef
51.
Marais BJ, Gie RP, Schaaf HS, Starke JR, Hesseling AC, Donald PR, Beyers N (2004) A proposed radiological classification of childhood intra-thoracic tuberculosis. Pediatr Radiol 34:886–894PubMedCrossRef
52.
Marais BJ, Gie RP, Hesseling AC, Schaaf HS, Lombard C, Enarson DA, Beyers N (2006) A refined symptom-based approach to diagnose pulmonary tuberculosis in children. Pediatrics 118:1350–1359CrossRef
53.
Marais BJ, Gie RP, Schaaf HS, Hesseling AC, Enarson DA, Beyers N (2006) The spectrum of disease in children treated for tuberculosis in a highly endemic area. Int J Tuberc lung Dis 10:732–738PubMed
54.
Martin C (2005) The dream of a vaccine against tuberculosis; New vaccines improving or replacing BCG? Eur Respir J 26:162–167PubMedCrossRef
55.
Matulis G, Jüni P, Villiger PM, Gadola SD (2007) Detection of latent tuberculosis in immunosuppressed patients with autoimmune diseases performance of a mycobacteroim tuberculosis antigen specific IFN-gamma assay. Ann Rheum Dis 67:84–90PubMedCrossRef
56.
Menzies D, Pai M, Comstock G (2007) Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med 146:350–354
57.
Nakaoka H, Lawson L, Squire SB, Coulter B, Ravn P, Brock I, Hart CA, Cuevas LE (2006) Risk for tuberculosis among children. Emerg Infect Dis 12:1383–1388PubMed
58.
National Institute for Health and Clinical Excellence. (2006) Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. http://​www.​nice.​org.​uk. Accessed 10 April 2008
59.
Neutra MR, Mantis NJ, Kraehenbuhl JP (2001) Collaboration of epithelial cells with organized mucosal lymphoid tissues. Nat Immunol 2:1004–1009PubMedCrossRef
60.
O’Brien RJ, Spigelman M (2005) New drugs for tuberculosis: current status and future prospects. Clin Chest Med 26:327–340PubMedCrossRef
61.
62.
Ozuah PO, Ozuah TP, Stein REK, Burton W, Mulvihill M (2001) Evaluation of a risk assessment questionnaire used to target tuberculin skin testing in children. JAMA 285:451–453PubMedCrossRef
63.
Pai M, Kalantri S, Dheda K (2006) New tools and emerging technologies for the diagnosis of tuberculosis: part I. Latent tuberculosis. Expert Rev Mol Diagn 6:413–422PubMedCrossRef
64.
Pai M, Joshi R, Bandyopadhyay M, Narang P, Dogra S, Taksande B, Kalantri S (2007) Sensitivity of a whole-blood interferon-gamma assay among patients with pulmonary tuberculosis and variations in T-cell responses during anti-tuberculosis treatment. Infection 35:98–103PubMedCrossRef
65.
Piana F, Ruffo Codecasa L, Baldan R, Miotto P, Ferrarese M, Cirillio DM (2007) Use of T-SPOT.TB in latent tuberculosis infection diagnosis in general and immunosuppressed populations. New Microbiol 30:286–290PubMed
66.
Ridzon R, Meador J, Maxwell R, Higgins K, Weismuller P, Onorato IM (1997) Asymptomatic hepatitis in persons who received alternative preventive therapy with pyrazinamide and ofloxacin. Clin Infect Dis 24:1264–1265PubMed
67.
Robert Koch-Institut (2005) Infektionsepidemiologisches Jahrbuch für 2004. Robert Koch-Institut, Berlin, pp 162–165
68.
Romanus V, Hallander H, Wahlen P, Olinder-Nielsen A, Magnusson P, Juhlin I (1995) Atypical mycobacteria in extrapulmonary disease among children. Incidence in Sweden from 1969 to 1990, related to changing BCG-vaccination. Tuber Lung Dis 76:300–310PubMedCrossRef
69.
Sacchettini JC, Rubin EJ, Freundlich JS (2008) Drugs versus bugs: in pursuit of the persistent predator Mycobacterium tuberculosis. Nat Rev Microbiol 6:41–52PubMedCrossRef
70.
Schoeman JF, Van Zyl LE, Laubscher JA, Donald PR (1997) Effect of corticosteroids on intracranial pressure, computed tomographic findings, and clinical outcome in young children with tuberculous meningitis. Pediatrics 99:226–231PubMedCrossRef
71.
Sharma SK, Mohan A, Sharma A, Mitra DK (2005) Miliary tuberculosis: new insights into an old disease. Lancet Infect Dis 5:415–430PubMedCrossRef
72.
Skevaki CL, Kafetzis DA (2005) Tuberculosis in neonates and infants: epidemiology, pathogenesis, clinical manifestations, diagnosis, and management issues. Paediatr Drugs 7:219–234PubMedCrossRef
73.
Spyridis NP, Spyridis PG, Gelesme A, Sypsa V, Valianatou M, Metsou F, Gourgiotis D, Tsolia MN (2007) The effectiveness of a 9-month regimen of isoniazid alone versus 3- and 4-month regimens of isoniazid plus rifampin for treatment of latent tuberculosis infection in children: results of an 11-year randomized study. Clin Infect Dis 45:715–722PubMedCrossRef
74.
Starke JR (2006) Interferon-gamma release assays for diagnosis of tuberculosis infection in children. Pediatr Infect Dis J 25:941–942PubMedCrossRef
75.
Steingart KR, Henry M, Laal S, Hopewell PC, Ramsay A, Menzies D, Cunningham J, Weldingh K, Pai M (2007) Commercial serological antibody detection tests for the diagnosis of pulmonary tuberculosis: a systematic review. PLoS Med 4:e202PubMedCrossRef
76.
Swaminathan S, Raghavan A, Duraipandian M, Kripasankar AS, Ramachandran P (2005) Short-course chemotherapy for paediatric respiratory tuberculosis: 5-year report. Int J Tuberc Lung Dis 9:693–696PubMed
77.
Thee S, Detjen A, Quarcoo D, Wahn U, Magdorf K (2007) Ethambutol in paediatric tuberculosis: aspects of ethambutol serum concentration, efficacy and toxicity in children. Int J Tuberc Lung Dis 11:965–971PubMed
78.
Thuong NT, Hawn TR, Thwaites GE, Chau TT, Lan NT, Quy HT, Hieu NT, Aderem A, Hien TT, Farrar JJ, Dunstan SJ (2007) A polimorphism in human TLR2 is associated with increased susceptibility to tuberculous meningitis. Genes Immun 8:422–428PubMedCrossRef
79.
Thwaites GE, Macmullen-Price J, Tran TH, Pham PM, Nguyen TD, Simmons CP, White NJ, Tran TH, Summers D, Farrar JJ (2007) Serial MRI to determine the effect of dexamethasone on the cerebral pathology of tuberculous meningitis: an observational study. Lancet Neurol 6:230–236PubMedCrossRef
80.
Tsiouris SJ, Austin J, Toro P, Coetzee D, Weyer K, Stein Z, El-Sadr WM (2006) Results of a tuberculosis-specific IFN-gamma assay in children at high risk for tuberculosis infection. Int J Tuberc Lung Dis 10:939–941PubMed
81.
Ulrichs T, Kaufmann SHE (2003) Immunology and persistence. Issues Infect Dis 2:112–127CrossRef
82.
Verver S, van Loenhout-Rooyackers JH, Bwire R, Annee-van Bavel JA, de Lange HJ, van Gerven PJ, Borgdorff MW (2005) Tuberculosis infection in children who are contacts of immigrant tuberculosis patients. Eur Respir J 26:126–132PubMedCrossRef
83.
World Health Organisation (2006) Guidance for national tuberculosis programmes on the management of tuberculosis in children. WHO/HTM/ TB/2006.371. WHO, Geneva
84.
World Health Organisation (2006) Ethambutol efficacy and toxicity. Literature review and recommendations for daily and intermittent dosage in children. WHO/HTM/TB/2006.365; WHO/FCH/CAH/2006.3. WHO, Geneva
85.
Wiese-Posselt M, Siedler A, Rademacher A, Haas W (2004) ESPID-study-group 2 incidence of nontuberculous mycobacteria (NTM) in children aged <15 years, Germany 2002–2004. ESPID annual meeting, Tampere, Finland, May 2004
86.
Zar HJ, Hanslo D, Apolles P (2005) Induced sputum versus gastric lavage for microbiological confirmation of pulmonary tuberculosis in infants and young children: a prospective study. Lancet 365:130–134PubMedCrossRef
Metadata
Title
Proposed management of childhood tuberculosis in low-incidence countries
Authors
Klaus Magdorf
Anne K. Detjen
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 8/2008
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-008-0730-1

Other articles of this Issue 8/2008

European Journal of Pediatrics 8/2008 Go to the issue

Original Paper

Autoimmune gastritis and parietal cell reactivity in two children with abnormal intestinal permeability

Short Report

Parotitis and acute pancreatitis in a patient with ulcerative colitis

Short Report

Acute renal failure due to rhabdomyolysis in a child with McArdle disease

Review

What’s new in cystic fibrosis? From treating symptoms to correction of the basic defect

Short Report

An 8-year-old boy with autoimmune hepatitis and Candida onychosis as the first symptoms of autoimmune polyglandular syndrome (APS1): identification of a new homozygous mutation in the autoimmune regulator gene (aire)

Original Paper

Blue rubber bleb nevus syndrome with simultaneous neurological and skeletal involvement