Risk factors for infection and disease in child contacts of multidrug-resistant tuberculosis : a cross-sectional study

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dc.contributor.authorSeddon, James A.
dc.contributor.authorHesseling, Anneke C.
dc.contributor.authorGodfrey-Faussett, Peter
dc.contributor.authorFielding, Katherine
dc.contributor.authorSchaaf, H. Simonen_ZA
dc.date.accessioned2014-01-30T09:46:35Z
dc.date.available2014-01-30T09:46:35Z
dc.date.issued2013-08
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.en_ZA
dc.descriptionThe original publication is available at http://www.biomedcentral.com/bmcinfectdis/en_ZA
dc.description.abstractBackground: Young children exposed to Mycobacterium tuberculosis have a high risk of disease progression following infection. This study aimed to determine risk factors for M. tuberculosis infection and disease in children following exposure to adults with multidrug-resistant (MDR) tuberculosis (TB). Methods: Cross-sectional study; all children aged < 5 years, routinely referred per local guidelines to the provincial specialist MDR-TB clinic, Western Cape Province, South Africa, following identification as contacts of adult MDR-TB source cases, were eligible for enrolment from May 2010 through April 2011. Demographic, clinical and social characteristics were collected. All children underwent HIV and tuberculin skin testing. Results: Of 228 children enrolled (median age: 30 months), 102 (44.7%) were classified as infected. Of these, 15 (14.7%) had TB disease at enrolment. Of 217 children tested for HIV, 8 (3.7%) were positive. In adjusted analysis, child’s age (AOR: 1.43; 95% CI: 1.13-1.91; p = 0.002) and previous TB treatment history (AOR: 2.51; 95% CI: 1.22-5.17; p = 0.01) were independent risk factors for infection. Increasing age of the MDR-TB source case (AOR: 0.67; 95% CI: 0.45-1.00; p = 0.05) was protective and source case alcohol use (AOR: 2.59; 95% CI: 1.29-5.22; p = 0.007) was associated with increased odds of infection in adjusted analysis. Decreasing age of the child (p = 0.01) and positive HIV status (AOR: 25.3; 95% CI: 1.63-393; p = 0.01) were associated with prevalent TB disease. Conclusion: A high proportion of children exposed to MDR-TB are infected or diseased. Early contact tracing might provide opportunities to prevent the progression to TB disease in children identified as having been exposed to MDR-TB.en_ZA
dc.description.sponsorshipStellenbosch Universityen_ZA
dc.description.versionPublishers' versionen_ZA
dc.identifier.citationSeddon, J. et al. 2013. Risk factors for infection and disease in child contacts of multidrug-resistant tuberculosis: a cross-sectional study. BMC Infectious Diseases, 13:392, doi:10.1186/1471-2334-13-392.en_ZA
dc.identifier.issn1471-2334 (print)
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi:10.1186/1471-2334-13-392
dc.identifier.urihttp://hdl.handle.net/10019.1/86101
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectCommunicable diseases in children -- Risk factors -- South Africa -- Western Cape -- Researchen_ZA
dc.subjectDrug resistant tuberculosis - Transmissionen_ZA
dc.subjectTuberculosis -- Transmission -- Children -- South Africa -- Western Cape -- Researchen_ZA
dc.subjectTuberculosis in children -- Preventionen_ZA
dc.subjectTuberculosis in children -- Diagnosisen_ZA
dc.titleRisk factors for infection and disease in child contacts of multidrug-resistant tuberculosis : a cross-sectional studyen_ZA
dc.typeArticleen_ZA
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