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Free Content Trends in the epidemiology of childhood tuberculosis in Greece

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SETTING: A hospital referral center for childhood tuberculosis (TB).

OBJECTIVE: To evaluate the epidemiological and clinical features of childhood TB in the Greater Athens area in the last decade.

DESIGN: We retrospectively reviewed the medical records of patients aged <14 years treated for active TB between January 2000 and December 2009 at our pediatric TB clinic and compared the results with the patient turnover during the previous decade (1990–1999). Data concerning demographic and clinical characteristics were analyzed.

RESULTS: A total of 321 children (median age 5.57 years, 157 males) with active TB were identified. About one third originated from areas where TB was previously recognized to be highly endemic. Twenty-three children (7%) had extra-pulmonary TB, and 61% of them originated from TB-endemic areas. Bacteriological confirmation was obtained in 40% of patients from whom specimens were obtained: 1 of 26 (3.8%) strains was multidrug-resistant. Most cases with drug-resistant Mycobacterium tuberculosis were noted among immigrant children. The average annual TB incidence was estimated at 5.37 per 100 000 for children aged <14 years in the Greater Athens area. Time trend analysis for the 20-year period revealed a significant reduction in the total number of TB cases (P = 0.002) and in TB among children from low-incidence countries (P < 0.0001).

CONCLUSIONS: In our settings, active TB is decreasing among children of Greek origin; disease epidemiology and drug resistance is influenced by the increasing influx of immigrants from areas where the disease is highly prevalent.

Keywords: children; drug resistance; epidemiology; immigration; tuberculosis

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.10.0717

Affiliations: 1: Second Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece 2: First Department of Paediatrics, P and A Kyriakou Children's Hospital, Athens, Greece 3: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA 4: National Reference Laboratory for Mycobacteria, Sotiria Chest Diseases Hospital, Athens, Greece 5: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

Publication date: June 1, 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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