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Pulmonary tuberculosis in children

Ursula K Rohlwink, Naomi F Walker, Alvaro A Ordonez, Yifan J Li, Elizabeth W Tucker, Paul T Elkington, Robert J Wilkinson, Katalin A Wilkinson
Tuberculosis (TB) remains the single biggest infectious cause of death globally, claiming almost two million lives and causing disease in over 10 million individuals annually. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes with various physiological roles implicated as key factors contributing to the spread of TB. They are involved in the breakdown of lung extracellular matrix and the consequent release of Mycobacterium tuberculosis bacilli into the airways. Evidence demonstrates that MMPs also play a role in central nervous system (CNS) tuberculosis, as they contribute to the breakdown of the blood brain barrier and are associated with poor outcome in adults with tuberculous meningitis (TBM)...
March 18, 2019: International Journal of Molecular Sciences
Rachel R Atherton, Fiona V Cresswell, Jayne Ellis, Sabrina B Kitaka, David R Boulware
Tuberculosis (TB) remains a significant, yet under-recognized cause of death in the pediatric population, with a WHO estimate of 1 million new cases of childhood TB in 2016 resulting in 250,000 deaths. Diagnosis is notoriously difficult; manifestations are protean due to the high proportion of cases of extra-pulmonary TB in children, and logistical problems exist in obtaining suitable specimens. These issues are compounded by the paucibacillary nature of disease with the result that an estimated 96% of pediatric TB-associated mortality occurs prior to commencing anti-tuberculous treatment...
2019: Frontiers in Pediatrics
Jianbing Zeng, Zhou Liu, Guanle Shen, Yuzhong Zhang, Li Li, Zhiqing Wu, Dehong Luo, Qingping Gu, Hui Mao, Liya Wang
OBJECTIVE: To evaluate the utility of magnetic resonance imaging (MRI) with an advanced motion correction technique in characterizing lung tissue changes and lesions induced by pulmonary tuberculosis (TB). SUBJECTS AND METHODS: Sixty-three subjects with computer tomography (CT) features of pulmonary TB received lung MRI. All subjects with pulmonary TB were confirmed by Acid-Fast Bacillus (AFB) Testing or detection of mycobacterium TB. T2-weighted turbo spin echo (TSE) sequence with the MultiVane motion correction technique was used to imaging lung...
March 11, 2019: International Journal of Infectious Diseases: IJID
Sadia Shakoor, Fatima Mir, Rumina Hasan
Background: Children evaluated for tuberculosis (TB) are often diagnosed with miscellaneous conditions that mimic TB. Knowledge of differentials informs policy on service provision through liaison with referral centers offering definitive diagnosis and treatment for common alternative disorders. Methods: We reviewed medical records of children who were offered diagnostic testing for TB (culture or Xpert MTB/RIF) at a tertiary care hospital in Karachi, Pakistan to identify common alternative diagnoses among children who are evaluated for TB...
January 2019: International Journal of Mycobacteriology
Clara Malka-Ruimy, Ghada Ben Youssef, Marion Lambert, Marie Tourret, Liana Ghazarian, Albert Faye, Sophie Caillat-Zucman, Véronique Houdouin
Mucosal associated invariant T (MAIT) cells are unconventional, semi-invariant T lymphocytes that recognize microbial-derived vitamin B2 (riboflavin) biosynthesis precursor derivatives presented by the monomorphic MHC class 1-related (MR1) molecule. Upon microbial infection, MAIT cells rapidly produce cytokines and cytotoxic effectors, and are thus important players in anti-microbial defense. MAIT cells are protective in experimental models of infection and are decreased in the blood of adult patients with bacterial infections, including Mycobacterium tuberculosis ( Mtb )...
2019: Frontiers in Immunology
Nkosana Jafta, Prakash M Jeena, Lars Barregard, Rajen N Naidoo
BACKGROUND: Crude measures of exposure to indicate indoor air pollution have been associated with the increased risk for acquiring tuberculosis. Our study aimed to determine an association between childhood pulmonary tuberculosis (PTB) and exposure to indoor air pollution (IAP), based on crude exposure predictors and directly sampled and modelled pollutant concentrations. METHODS: In this case control study, children diagnosed with PTB were compared to children without PTB...
March 7, 2019: BMC Public Health
Getahun Abate, Fahreta Hamzabegovic, Christopher S Eickhoff, Daniel F Hoft
Pulmonary non-tuberculous mycobacterial (NTM) infections particularly caused by Mycobacterium avium complex (MAC) and Mycobacterium abscessus (MAB) are becoming major health problems in the U.S. New therapies or vaccines which will help prevent the disease, shorten treatment duration and/or increase treatment success rates are urgently needed. This study was conducted with the objective of testing the hypothesis that Bacillus Calmette Guerin (BCG), a vaccine used for prevention of serious forms of tuberculosis (TB) in children and adolescents in tuberculosis hyperendemic countries, induces cross-protective T cell immunity against Mycobacterium avium (MAV) and MAB...
2019: Frontiers in Immunology
S Dhaked, N Sharma, K K Chopra, A Khanna, R Kumar
BACKGROUND: India accounts for one fourth of the global tuberculosis (TB) burden. In 2015, an estimated 28 lakh cases occurred and 4.8 lakh people died due to TB and proportion of children among new TB patients was 6% in 2016. The clinical presentation of childhood TB is extremely variable, therefore the study attempted to understand, the socio-demographic profile of pediatric tuberculosis patients, and the treatment outcomes under Revised National Tuberculosis Control Program (RNTCP)...
January 2019: Indian Journal of Tuberculosis
Muhammad Osman, Elizabeth P Harausz, Anthony J Garcia-Prats, H Simon Schaaf, Brittany K Moore, Robert M Hicks, Jay Achar, Farhana Amanullah, Pennan Barry, Mercedes Becerra, Domnica I Chiotan, Peter C Drobac, Jennifer Flood, Jennifer Furin, Medea Gegia, Petros Isaakidis, Andrei Mariandyshev, Iveta Ozere, N Sarita Shah, Alena Skrahina, Elena Yablokova, James A Seddon, Anneke C Hesseling
Extensively drug-resistant tuberculosis (XDR TB) has extremely poor treatment outcomes in adults. Limited data are available for children. We report on clinical manifestations, treatment, and outcomes for 37 children (<15 years of age) with bacteriologically confirmed XDR TB in 11 countries. These patients were managed during 1999-2013. For the 37 children, median age was 11 years, 32 (87%) had pulmonary TB, and 29 had a recorded HIV status; 7 (24%) were infected with HIV. Median treatment duration was 7...
March 2019: Emerging Infectious Diseases
James Gaensbauer, Richard Broadhurst
PURPOSE OF REVIEW: Tuberculosis is leading cause of global morbidity and mortality and a significant proportion of the burden of disease occurs in children. In the past 5 years, a number of innovations have improved the diagnosis and treatment for children with both latent tuberculosis infection and active disease. RECENT FINDINGS: This review discusses three key areas of innovation. First, we assess utilization and performance of interferon-gamma release assays (IGRAs) in different clinical and epidemiologic scenarios...
February 15, 2019: Current Infectious Disease Reports
André N H Bulabula, Jenna A Nelson, Eric M Musafiri, Rhoderick Machekano, Nadia A Sam-Agudu, Andreas H Diacon, Maunank Shah, Jacob Creswell, Grant Theron, Robin M Warren, Karen R Jacobson, Jean-Paul Chirambiza, Dieudonné Kalumuna, Bertin C Bisimwa, Patrick D M C Katoto, Michel K Kaswa, Freddy M Birembano, Liliane Kitete, Martin P Grobusch, Zacharie M Kashongwe, Jean B Nachega
Background: Multidrug-resistant tuberculosis (MDR-TB) jeopardizes global TB control. The prevalence and predictors of Rifampicin-resistant (RR) TB, a proxy for MDR-TB, and the treatment outcomes with standard and shortened regimens have not been assessed in post-conflict regions, such as the South Kivu province in the eastern Democratic Republic of the Congo (DRC). We aimed to fill this knowledge gap and to inform the DRC National TB Program. Methods: of adults and children evaluated for pulmonary TB by sputum smear microscopy and Xpert MTB/RIF (Xpert) from February 2012 to June 2017...
February 13, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Doreen Nabukalu, Moses Ntaro, Mathias Seviiri, Raquel Reyes, Matthew Wiens, Radhika Sundararajan, Edgar Mulogo, Ross M Boyce
BACKGROUND: In much of sub-Saharan Africa, health facilities serve as the primary source of routine vital statistics. These passive surveillance systems, however, are plagued by infrequent and unreliable reporting and do not capture events that occur outside of the formal health sector. Verbal autopsies (VA) have been utilized to estimate the burden and causes of mortality where civil registration and vital statistics systems are weak, but VAs have not been widely employed in national surveillance systems...
2019: PloS One
M K Khan, M N Islam, J Ferdous, M M Alam
Tuberculosis (TB) is a progressive granulomatous infectious disease caused by the gram positive, acid fast bacilli classified under the genus Mycobacterium. Tuberculosis in human is mostly by Mycobacterium tuberculosis and primarily affects lungs causing pulmonary tuberculosis. It can also affect intestine, meninges, bones, joints, lymph nodes, skin and other tissues of the body causing extra-pulmonary tuberculosis. Human TB is transmitted mainly through droplet infection and droplet nuclei. Infection of human with M...
January 2019: Mymensingh Medical Journal: MMJ
Anaïs Briquet, Rithy Vong, Jean-Baptiste Roseau, Emilie Javelle, Nicolas Cazes, Fréderic Rivière, Marc Aletti, Marie-Pierre Otto, Cécile Ficko, Sandrine Duron, Michel Fabre, Christine Pourcel, Fabrice Simon, Charles Soler
Background: Mycobacterium canettii forms part of the Mycobacterium tuberculosis complex. M. canettii infections are mainly described in the Horn of Africa. The permanent presence of French soldiers in Djibouti raises the question of the risk of being infected with M. canettii. Our study aims to describe M. canettii infections among French military or their families between 1998 and 2015. Methods: This retrospective study relied on 3 sources of data: the reference centre for mycobacteria in the Biology Department at Percy military hospital in Paris, the French Military Center for Epidemiology and Public Health, and the scientific literature...
February 7, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Isha Saini, Aparna Mukherjee, Hitender Gautam, Mohit Singla, K R Jat, Rakesh Lodha, Urvashi B Singh, S K Kabra
OBJECTIVE: To evaluate utility of Xpert MTB/RIF in bronchoalveolar lavage fluid in children with probable pulmonary tuberculosis. METHODS: Children with probable pulmonary tuberculosis with negative smear and Xpert on induced sputum/gastric aspirate were subjected to bronchoalveolar lavage (BAL) for Xpert assay and mycobacterial liquid culture. Data of children <14 y undergoing bronchoscopy for suspected MDR-TB (n=12) were also analyzed. The sensitivity of Xpert in BAL fluid for diagnosis of probable and confirmed pulmonary tuberculosis was calculated with clinico-radiological diagnosis and culture as gold standards, respectively...
December 15, 2018: Indian Pediatrics
Agam Jain, Rakesh Lodha
Tuberculosis (TB), once widely prevalent throughout the world, experienced falling incidence rates in early twentieth century in developed nations, even before the introduction of anti-TB drugs, attributed to improved hygiene and living conditions. Active TB may develop following fresh infection or activation of latent tuberculosis infection (LTBI). LTBI is a state of persistent bacterial viability, however, the host stays asymptomatic and there is no evidence of clinically active tuberculosis. Therefore, treatment of all LTBI is considered as one of the ways to control tuberculosis...
February 11, 2019: Indian Journal of Pediatrics
Chrysoula Perdikogianni, Maria Raissaki, Athanasia Christidou, Emmanouil Galanakis
Cavitary pulmonary tuberculosis in children is uncommon in areas with a low tuberculosis burden. We present two cases in an 11-year old immunocompetent girl and an 8-year old immunocompromised boy. Both children were immigrants. No other cavitary tuberculosis cases have been observed in a population of 103,781 children in Crete, Greece for the past 25 years. Conclusion: Severe forms of tuberculosis may re-emerge and BCG vaccination should remain part of the immunisation programme in immigrant populations...
2019: Respiratory Medicine Case Reports
Roopali Rajput, Paras Singh, Rohit Sarin, Prabhpreet Sethi, Sangeeta Sharma
BACKGROUND: Confirmatory diagnosis of extra-pulmonary tuberculosis remains a true challenge owing to difficulty in procuring appropriate specimen, inefficient laboratory methods and paucibacillary nature of infection. These obstructions become all the very difficult in pediatric EPTB cases, due to non-specific clinical signs and symptoms, low sensitivity of smear microscopy and culture, lack of awareness among clinicians, etc. AIM OF THE STUDY: The present study aimed to evaluate the diagnostic accuracy of rapid and cost-effective loop-mediated isothermal amplification (LAMP) assay for EPTB diagnosis in children...
January 28, 2019: Journal of Microbiological Methods
Anuradha Dawani, Arun Kumar Gupta, Manisha Jana
Extrapulmonary tuberculosis in children tends to be more severe than the adults. It can affect almost any organ system of the body. The clinical manifestations are often non-specific. Imaging findings are also not always very specific. This article describes the imaging spectrum of pediatric extrapulmonary tuberculosis.
January 30, 2019: Indian Journal of Pediatrics
Madeeha Laghari, Syed Azhar Syed Sulaiman, Amer Hayat Khan, Naheed Memon
BACKGROUND: Understanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success. Treatment completion for TB is the mainstay of TB prevention and control. The study was aimed to assess the treatment outcomes and predictors for unsuccessful outcomes among children with TB. METHODS: This was a prospective multicenter study conducted in Sindh. Children aged ≤14 years enrolled from June to November 2016 were included...
January 24, 2019: BMC Infectious Diseases
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