Tuberculosis in childhood: a systematic review of national and international guidelines

被引:34
作者
Berti, Elettra [1 ]
Galli, Luisa [1 ]
Venturini, Elisabetta [1 ]
de Martini, Maurizio [1 ]
Chiappini, Elena [1 ]
机构
[1] Univ Florence, Meyer Children Univ Hosp, Dept Hlth Sci, Florence, Italy
关键词
GAMMA RELEASE ASSAYS; MYCOBACTERIUM-TUBERCULOSIS; CHILDREN; DIAGNOSIS; RECOMMENDATIONS; MANAGEMENT; INFECTION; DISEASE;
D O I
10.1186/1471-2334-14-S1-S3
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Paediatric tuberculosis (TB) represents a major public health concern worldwide. About 1 million children aged less than 15 years develop TB each year, contributing to 3-25% of the total TB caseload. The aim of this review is to evaluate national and international guidelines concerning tuberculosis in childhood and compare them in terms of diagnosis and treatment strategies. Methods: A literature search of the Pubmed database was performed from January 2000 to August 2013, using the terms "tuberculosis" and "children". The search was limited to guidelines and consensus conferences, human species and full text availability, with no language restrictions. Results: Twenty-seven national and international guidelines are identified. Several discrepancies on the diagnosis workup of TB are underlined. The main points of disagreement are represented by the interpretation of tuberculin skin test (TST) result and the recommendations on the use of TST and/or interferon-gamma release assay (IGRA) for the diagnosis of TB infection. Otherwise, all guidelines are in agreement that a microbiological confirmation should always be sought. Similarly, susceptibility drug testing and genotyping should be performed whenever it is possible on the basis of resources availability. On the contrary, the use of nucleic acid amplification tests (NAATs) for the M. tuberculosis detection is still controversial. A general consensus exists, otherwise, on TB treatment and only minor discrepancies are evidenced, such as the recommendations on daily or intermittent treatment regimens. Conclusions: Despite advances in TB diagnostic tools have been reached during the last decade, a lack of uniformity in their availability, indication and interpretation has relevant consequences for clinical practice. Further studies need to be performed to clarify this issue and identify a reliable and reproducible diagnostic workup. Moreover, future studies should analyze the drug metabolism and the efficacy of intermittent dosing regimes in childhood, as well as new treatment regimens in order to improve the therapy compliance.
引用
收藏
页数:10
相关论文
共 40 条
[1]   Consensus Statement on Childhood Tuberculosis WORKING GROUP ON TUBERCULOSIS, INDIAN ACADEMY OF PEDIATRICS (IAP) [J].
Amdekar, Y. K. ;
Singh, Varinder ;
Kabra, Sushil K. ;
Sethi, G. R. .
INDIAN PEDIATRICS, 2010, 47 (01) :41-55
[2]  
[Anonymous], 2003, AM J RESP CRIT CARE, V167, P603
[3]  
Anonymous, 2009, Morbidity and Mortality Weekly Report, V58, P7
[4]  
[Anonymous], 2013, Canadian Tuberculosis Standards, V7
[5]  
[Anonymous], 2010, DESK GUID DIAGN MAN
[6]  
[Anonymous], 2012, MAN CONT MDR TB XDR
[7]   Evaluation of Molecular Tools for Detection and Drug Susceptibility Testing of Mycobacterium tuberculosis in Stool Specimens from Patients with Pulmonary Tuberculosis [J].
Cordova, Julianna ;
Shiloh, Ron ;
Gilman, Robert H. ;
Sheen, Patricia ;
Martin, Laura ;
Arenas, Fanny ;
Caviedes, Luz ;
Kawai, Vivian ;
Soto, Giselle ;
Williams, Diana L. ;
Zimic, Mirko ;
Roderick Escombe, A. ;
Evans, Carlton A. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2010, 48 (05) :1820-1826
[8]   Evaluation of Tuberculosis Diagnostics in Children: 2. Methodological Issues for Conducting and Reporting Research Evaluations of Tuberculosis Diagnostics for Intrathoracic Tuberculosis in Children. Consensus From an Expert Panela [J].
Cuevas, Luis E. ;
Browning, Renee ;
Bossuyt, Patrick ;
Casenghi, Martina ;
Cotton, Mark F. ;
Cruz, Andrea T. ;
Dodd, Lori E. ;
Drobniewski, Francis ;
Gale, Marianne ;
Graham, Stephen M. ;
Grzemska, Malgosia ;
Heinrich, Norbert ;
Hesseling, Anneke C. ;
Huebner, Robin ;
Jean-Philippe, Patrick ;
Kabra, Sushil Kumar ;
Kampmann, Beate ;
Lewinsohn, Deborah ;
Li, Meijuan ;
Lienhardt, Christian ;
Mandalakas, Anna M. ;
Marais, Ben J. ;
Menzies, Heather J. ;
Montepiedra, Grace ;
Mwansambo, Charles ;
Oberhelman, Richard ;
Palumbo, Paul ;
Russek-Cohen, Estelle ;
Shapiro, David E. ;
Smith, Betsy ;
Soto-Castellares, Giselle ;
Starke, Jeffrey R. ;
Swaminathan, Soumya ;
Wingfield, Claire ;
Worrell, Carol .
JOURNAL OF INFECTIOUS DISEASES, 2012, 205 :S209-S215
[9]   Interferon-γ release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis [J].
Detjen, A. K. ;
Keil, T. ;
Roll, S. ;
Hauer, B. ;
Mauch, H. ;
Wahn, U. ;
Magdorf, K. .
CLINICAL INFECTIOUS DISEASES, 2007, 45 (03) :322-328
[10]   Diagnostic standards and classification of tuberculosis in adults and children [J].
Dunlap, NE ;
Bass, J ;
Fujiwara, P ;
Hopewell, P ;
Horsburgh, CR ;
Salfinger, M ;
Simone, PM .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2000, 161 (04) :1376-1395