Tracking Tuberculosis in US Kids

Tuberculosis cases in children occurred more among those born overseas

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Tuberculosis is not a common disease in the US, but it does occur, even among children. So, who are those children?

A recent study looked at who those children were and what characteristics they shared.

The findings revealed that the majority of children at risk for tuberculosis were born overseas or were born in the US to parents born outside the US.

However, well over half of the children contracted their infections here in the US, not in another country.

"Ask a pediatrician about a child's excessive coughing."

This study, led by Jenny Pang, MD, MPH, of the Department of Epidemiology at the University of Washington in Seattle, aimed to estimate how common tuberculosis was in young children in the US.

The researchers relied on a sample of 20 regions throughout the US to identify all the cases of tuberculosis in children under 5 years old in 2005-2006.

Then, the researchers gathered additional information about each of the 364 cases, including the children's demographics, their immigration and travel background and information on where they likely contracted the disease.

Data from parents' interviews, the health department and medical records were also included.

The researchers found that tuberculosis occurred in children born overseas and now living in the US at a rate 32 times higher than that of children born in the US to US-born parents.

Even among the children born in the US, but to parents who were born overseas, the rate of tuberculosis was six times higher than among children with parents born in the US.

Just over half of the tuberculosis cases (53 percent) occurred among the children who were born in the US to parents who had been born overseas.

The researchers then compared all the children of foreign-born parents, looking at differences among the kids born in the US versus those born outside the US.

The children born in the US in this group were more likely to be Hispanic than children born overseas — 73 percent of the US-born children were Hispanic, compared to 37 percent of the children born abroad.

In addition, just under a third (30 percent) of the US-born kids with tuberculosis were infants, compared to 7 percent of the children with tuberculosis who had been born overseas.

The US-born children were also more likely to have been diagnosed based on who they had been in contact with.

Forty percent of US-born children were diagnosed based on tracing back their contacts with others, compared to only 7 percent of the foreign-born children.

It was also, unsurprisingly, more likely that the original source of the disease was identified in more cases with US-born kids than with foreign-born kids.

While health authorities had only been able to identify the source of the infection in 19 percent of the cases involving foreign-born children, they were able to identify the source in 61 percent of cases involving children born in the US. Yet, the children were not contracting the infection overseas and then coming to the US.

In fact, among all the cases, two thirds of the children had been exposed to tuberculosis in the US.

The researchers made several recommendations for addressing tuberculosis infections quickly and effectively based on these findings.

"Prompt diagnosis and treatment of adult source cases, effective contact investigations prioritizing young contacts, and targeted testing and treatment of latent TB infection are necessary to reduce TB morbidity in this population," the researchers wrote.

This study was published February 10 in the journal Pediatrics. The research was funded by the CDC, and the authors reported no conflicts of interest.

Review Date: 
February 12, 2014
Last Updated:
February 12, 2014