• Tomas M Perez-Porcuna, Antoni Noguera-Julian, Maria Teresa Riera-Bosch, Esperança Macià-Rieradevall, José Santos-Santiago, Maria Àngels Rifà Pujol, Maria Eril, Lídia Aulet-Molist, Emma Padilla-Esteba, Maria Teresa Tórtola, Jordi Gómez I Prat, Anna Vilamala Bastarras, Josep Sebastià Rebull-Fatsini, Andrea Papaleo, Neus Rius-Gordillo, Alessandra Q Gonçalves, Àngels Naranjo-Orihuela, Marta Urgelles, Mónica G García-Lerín, Gemma Jimenez-Lladser, Beatriz Lorenzo-Pino, Mónica Adriana Giuliano-Cuello, Maria Teresa Pascual-Sánchez, Mónica Marco-García, Rosa Abellana, Maria Espiau, Maria Nieves Altet-Gómez, Angels Orcau-Palau, Joan A Caylà, and Antoni Soriano-Arandes.
• TB Pediatric Unit, Research Foundation of Primary Health and Mútua Terassa University Hospital, Mútua Terrassa, Terrassa, Catalunya 08221, Spain.
• J Travel Med. 2024 Aug 3; 31 (6).

BackgroundMost paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR.MethodsWe conducted a prospective multicentric observational study in Catalonia (Spain) from June 2017 to December 2019. We enrolled children aged < 15 years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent's birth country for ≥21 days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8-12 weeks post-return. LTBI was defined as a TST ≥5 mm and/or a positive QFT-Plus.ResultsFive hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU, 95%CI = 8.8-28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3-9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU, 95%CI = 3.9-20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1-13.3).ConclusionsThe risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.© International Society of Travel Medicine 2024. Published by Oxford University Press.

34 keywords...

hide…