Epidemiology of tuberculosis in children in London, 2009–2011: are opportunities for prevention being missed?
OBJECTIVE: To explore missed opportunities (MO) for the prevention of tuberculosis (TB) in children aged 0–15 years.
DESIGN: Parents/guardians of children aged <15 years diagnosed with TB and reported through surveillance were interviewed about bacille Calmette-Guérin vaccination (MO-V) or contact tracing and screening for TB (MO-C) via an algorithm reflecting eligibility.
RESULTS: Annual TB incidence was 12 per 100 000 (65/100 000 in Black Africans, 20/100 000 in Indian or Pakistani children). The response rate was 36% (145/405). About 20% of UK-born children had not been vaccinated. MO-V was not associated with any particular factor. Contact with a known TB case before illness had occurred in 71 children (49%; 71% in those aged 0–1 years vs. 30% in those aged 11–15 years), of whom 64 (91%) were diagnosed through contact tracing. MO-C had been conducted in six (4% overall). Children with MO-C were all of Black ethnic origin. Their index cases were family members (within their household) or relatives or family friends from abroad (outside their household). MO-C was not associated with any other factor.
CONCLUSION: Although overall few missed opportunities for prevention had occurred, we recommend increased rigour when performing contact tracing in any case where a child may have been exposed.
Keywords: control; paediatric; prevention; tuberculosis
Document Type: Research Article
Affiliations: 1: Health Protection Agency, London Region Epidemiology Unit, London, UK; European Programme for Intervention Epidemiology Training, European Centre for Disease Control and Prevention, Stockholm, Sweden 2: Health Protection Agency, London Region Epidemiology Unit, London, UK 3: Department of Infectious Diseases, Great Ormond Street Hospital for Children NHS Trust, London, UK 4: Statistics, Modelling and Economics Department, Health Protection Services Colindale, Health Protection Agency, London, UK 5: London Health Programmes, London, UK
Publication date: 01 December 2013
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