Towards the elimination of paediatric tuberculosis in high-income, immigrant-receiving countries: A 25-year conventional and molecular epidemiological case study

Vivek Dhawan, Jennifer Bown, Angela Lau, Deanne Langlois-Klassen, Dennis Kunimoto, Ravi Bhargava, Linda Chui, Simon M. Collin, Richard Long*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

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.

Original languageEnglish
Article number00131-2017
JournalERJ Open Research
Volume4
Issue number2
DOIs
Publication statusPublished - 1 Apr 2018
Externally publishedYes

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© ERS 2018.

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