Abstract

Introduction

This study aimed to evaluate the clinical, radiological, and laboratory findings of children with a history of contact with bacteriologically confirmed contagious adult pulmonary tuberculosis (TB) cases; to determine the risk factors for tuberculosis infection (TBI) and active disease development; and to assess the effects of administered prophylactic treatment regimens on short-term prognosis.

Materials and Methods

This retrospective study included 106 children aged 0–18 years who had close contact with bacteriologically confirmed adult pulmonary TB cases between January 1, 2016 and August 2017. Clinical characteristics, contact history, radiological and microbiological findings, and treatment regimens of the cases were evaluated.

Results

The mean age of the cases was 92.7±56.5 months, and 56% were female. Household contact history was present in 85% of the children, and the mean duration of contact was 137.2±114.1 days. Of the evaluated children, 78% were classified as uninfected contacts, 16% as TBI, and 6% as active TB disease. Tuberculin skin test positivity was detected in 19% of the cases. The mean age of children diagnosed with active TB was significantly lower than that of children with TBI and uninfected contacts (p=0.030). Thoracic computed tomography was performed in 24 cases with suspicious radiological findings, and findings compatible with TB were detected in 5 cases. Of the 6 children diagnosed with active TB, 5 had pulmonary TB and 1 had tuberculous lymphadenitis. Acid-fast bacilli (AFB) smear examinations performed in 14 cases requiring further investigation were all negative, whereas culture positivity was detected in half of the cases diagnosed with tuberculosis disease. Isoniazid prophylaxis was administered to all children diagnosed as contacts or TBI, and no active disease developed during the six-month follow-up period.

Conclusion

Household contact and younger age were identified as important risk factors for the development of active TB in children. Early and systematic screening of child contacts and timely initiation of isoniazid prophylaxis were found to be effective in preventing disease development. These findings support that early evaluation and preventive treatment of child contacts are fundamental strategies in the control of childhood tuberculosis.