Tuberculosis contact tracing among children and adolescent referred to children's hospital in Rio de Janeiro, Brazil

ABSTRACT

Objective: To describe the investigation of latent tuberculosis infection and indication for isoniazid preventive therapy in children and adolescents evaluated at the children's hospital. Methods: This retrospective study examines all latent tuberculosis infection subjects with indication for isoniazid preventive therapy attended during 2002-2009 at the pulmonology outpatient clinic from children's hospital in Rio de Janeiro, Brazil. The subjects were classified into three groups by origin: (G1) primary and secondary health units; (G2) children's hospital-pulmonology outpatient clinic; and (G3) children's hospital-specialty outpatient clinics. The association between the variables examined and G1 was analyzed using uni- variate analysis. Results: Of the 286 latent tuberculosis infection cases included 169 (59.1%) were from G1, 56 (19.6%) from G2, and 61 (21.3%) from G3. Latent tuberculosis infection diagnosis without isoniazid preventive therapy prescription was present in 142 (49.6%) cases before arrival at the pulmonology outpatient clinic: 135 (95.1%) from G1, three (2.1%) from G2, and four (2.8%) from G3. Variables associated with G1 were presence of isoniazid preventive therapy criteria before attending the pulmonology outpatient clinic (OR: 62.3; 26.6-146.2), negative HIV infection status (OR: 9.44; 1.16-76.3); contact with pulmonary tuberculosis (OR: 5.57; 1.99-15.5), and residing in Rio de Janeiro city (OR: 1.89; 1.04-3.44). Conclusion: Strategies that increase latent tuberculosis infection identification and isoniazid preventive therapy prescription in primary and secondary health units are urgently needed. .