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Pediatr Infect Dis J. 1998 May;17(5):407-11.

Tuberculosis in children and adolescents: California, 1985 to 1995.

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1
University of California, Department of Pediatrics, San Francisco, USA.

Abstract

OBJECTIVES:

To describe the epidemiology and clinical characteristics of tuberculosis (TB) among children and adolescents and to define children at risk for TB.

SETTING:

4607 children 0 to 14 years of age and 1615 adolescents 15 to 19 years of age reported with TB in California.

METHODS:

We analyzed surveillance data reported to the California Department of Health Services TB Control Branch from 1985 through 1995.

RESULTS:

TB cases increased 22% among children 0 to 4 years of age and 66% among children 5 to 14 from 1985 through 1995. Case rates were highest among children 0 to 4 years of age (13/ 100000 children), but declined from 1993 to 1995, except for black children 0 to 4 years of age. Minority children 0 to 14 years of age had case rates 6- to 34-fold higher than did white children. Pulmonary TB was the most common site of disease in all age groups (71 to 82%). TB meningitis was most common in children 0 to 4 years of age (5%). Most children (64%) did not have cultures done; however, among culture-proved cases isoniazid-resistant Mycobacterium tuberculosis was isolated in 7%. Adolescents were more likely to have cavitary pulmonary disease (24%), to be foreign-born (78%) or homeless (4%) and to have an isoniazid-resistant strain isolated (13%) than were children 0 to 14 years of age (P < 0.05).

CONCLUSIONS:

TB in children and adolescents increased substantially in the mid-1980s and early 1990s. Pediatric TB remains a serious health problem, especially among minority children and adolescents. Our findings indicate that TB control programs need improved strategies to prevent infection and detect disease in this population.

[Indexed for MEDLINE]

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