PT  - JOURNAL ARTICLE
AU  - Dhawan, Vivek
AU  - Bown, Jennifer
AU  - Lau, Angela
AU  - Langlois-Klassen, Deanne
AU  - Kunimoto, Dennis
AU  - Bhargava, Ravi
AU  - Chui, Linda
AU  - Collin, Simon M.
AU  - Long, Richard
TI  - Towards the elimination of paediatric tuberculosis in high-income, immigrant-receiving countries: a 25-year conventional and molecular epidemiological case study
AID  - 10.1183/23120541.00131-2017
DP  - 2018 Apr 01
TA  - ERJ Open Research
PG  - 00131-2017
VI  - 4
IP  - 2
4099  - http://openres.ersjournals.com/content/4/2/00131-2017.short
4100  - http://openres.ersjournals.com/content/4/2/00131-2017.full
SO  - erjor2018 Apr 01; 4
AB  - 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.Conventional and molecular epidemiology can inform paediatric TB elimination strategy in high-income countries http://ow.ly/mwbn30iY1WF