Abstract
The epidemiology of tuberculosis (TB) in high-income countries is increasingly dictated by immigration. The influence of this trend on paediatric TB and TB elimination are not well defined.
We undertook a 25-year conventional and molecular epidemiologic study of paediatric TB in Alberta, one of four major immigrant-receiving provinces in Canada. All isolates of Mycobacterium tuberculosis were DNA fingerprinted using standard methodology.
Between 1990 and 2014, 176 children aged 0–14 years were diagnosed with TB. Foreign-born children or Canadian-born children of foreign-born parents accounted for an increasingly large proportion of total cases during the study period (from 32.1% to 89.5%). Of the 78 culture-positive cases, 35 (44.9%) had a putative source case identified by conventional epidemiology, with 34 (97.1%) having a concordant molecular profile. Of the remaining 43 culture-positive cases, molecular profiling identified spatially and temporally related sources in six cases (14.0%). These six children, along with four other children whose source cases were discovered through reverse-contact tracing, had a high morbidity and mortality.
The increasing burden of paediatric TB in both foreign-born children and Canadian-born children of foreign-born parents calls for more timely diagnosis of source cases and more targeted screening for latent TB infection.
Abstract
Conventional and molecular epidemiology can inform paediatric TB elimination strategy in high-income countries http://ow.ly/mwbn30iY1WF
Footnotes
Conflict of interest: R. Long reports receiving grants from the Canadian Institutes of Health Research (CIHR) during the conduct of the study.
Support statement: This study was supported by a grant from the Canadian Institutes of Health Research (CIHR) (number 125961). D. Langlois-Klassen was a recipient of a CIHR Postdoctoral Fellowship. J. Bown was a Masters student at the London School of Hygiene and Tropical Medicine. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received October 26, 2017.
- Accepted March 9, 2018.
- Copyright ©ERS 2018
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