High tuberculosis transmission rate in children with nursery exposure to undetected pulmonary tuberculosis
OBJECTIVE: To evaluate tuberculosis (TB) transmission from a health care worker with active pulmonary TB to neonatal contacts.
DESIGN: For the first investigation, infants who had been in the nursery 3 months before the index patient was diagnosed with pulmonary TB were enrolled. After a child who had stayed in the nursery 10 months before the diagnosis of the index patient was diagnosed with tuberculous meningitis, a second contact investigation was conducted.
RESULTS: Respectively 315 and 1334 children participated in the first and second investigations. The mean age of the contacts was 66.3 days; the rate of latent tuberculous infection (LTBI) at the first investigation was 42.5% (134/315). Only one infant had an abnormal chest X-ray, and was thought to have pulmonary TB. In the second investigation, the mean age of the participants was 17.6 months. The proportion of children with LTBI was 18.7% (249/1334).
CONCLUSIONS: The LTBI rate in the present study was much higher than that estimated from other contact investigations. To minimise the risk of nosocomial TB transmission to neonates, screening and management of TB in health care workers should be strengthened.
Keywords: latent tuberculous infection; newborn; nurseries; pulmonary TB
Document Type: Research Article
Affiliations: 1: Department of Paediatrics, Kosin University College of Medicine, Busan 2: Division of Healthcare Resources Policy, Ministry of Health and Welfare, Sejong 3: Division of Chronic Disease Control 4: Division of TB Epidemic Investigation, Korea Centers for Disease Control and Prevention (KCDC), Osong 5: Division of Bacterial Disease Research, Korea National Institute of Health, Osong 6: Division of Bacterial Disease 7: Center for Disease Prevention, KCDC, Osong 8: Department of Paediatrics, Pusan National University School of Medicine, Busan, Republic of Korea
Publication date: 01 September 2018
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