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Free Content The clinical epidemiology of childhood pulmonary tuberculosis: a critical review of literature from the pre-chemotherapy era [State of the Art]

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The pre-chemotherapy literature represents an impressive body of evidence that clarifies important epidemiological concepts in childhood tuberculosis. Reports describe the major transitions in tuberculosis, from exposure to infection and from infection to disease (morbidity and mortality), without the influence of chemotherapy. Children with household exposure to a sputum smear-positive source case experienced the greatest risk of becoming infected and of developing subsequent disease. Household exposure to a sputum smear-negative source case or non-household exposure still posed an appreciable, although greatly reduced, risk. Infection in children less than 2 years of age indicated a probable household source case. The majority of older children who were infected did not have a household source identified, and presumably became infected in the community. The annual risk of infection (ARI) was not constant across all ages, but seemed to increase during periods of widening social contact. Infants and adolescents were the groups at highest risk for disease development and death following primary infection.
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Keywords: childhood pulmonary tuberculosis; epidemiology; pre-chemotherapy; review

Document Type: Miscellaneous

Affiliations: 1: Centre for TB Research and Education and the Department of Paediatrics and Child Health, Tygerberg Children's Hospital and the Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa 2: Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: International Union Against Tuberculosis and Lung Disease, Paris, France

Publication date: March 1, 2004

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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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