Tuberculosis among children visiting friends & relatives.

BACKGROUND: Most 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. METHODS: We 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. RESULTS: Five 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). CONCLUSIONS: The 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.

[Pre/post assessment of an HIV infection prevention intervention targeted at teenagers in Southern Tarragona, Spain]. / Evaluación pre-post de una actividad preventiva de la infección por VIH dirigida a los adolescentes de las comarcas del sur de Tarragona.

BACKGROUND: Human immuno-deficiency virus (HIV) infection is one of the leading public health problems in our country. Preventive education has shown itself to be a useful tool for curtailing this disease. The objective of this study is that of assessing the effectiveness of a preventive intervention at the Secondary Schools in the Baix Ebre and Montsià areas of the Tortosa Healthcare District aimed at reducing the risk of HIV transmission and furthering the knowledge of this disease. METHOD: A pre/post intervention study was conducted with no control group. A total of 19 schools, corresponding to the fourth year of Compulsory Secondary Education and first year of "Bachillerato" studies were invited to participate. The activity consisted of a workshop 60-90 minutes in length, in conjunction with educational material. A questionnaire was used as the gauging tool. RESULTS: Twelve schools agreed to participate, a total of 896 answers having been gotten for the pre-test and 805 answers for the post-test. A statistically significant increase was found for 52% (10/19) of the items regarding the correct answers on the post-test. A statistically significant improvements was found in four of the five items (80%) related to attitudes, and in five of the eight (62.5%) items related to overall knowledge of this infection following the intervention. A statistically significant improvement regarding prevention-related knowledge was found solely in one of the six items (16.6%). CONCLUSIONS: Preventive activities in the form of participational workshops are a good way of furthering the knowledge and improving the attitudes regarding HIV/AIDS of the participating teenagers. As no curative treatment exists for this disease, prevention from the educational realm is of importance for curtailing increased HIV transmission.

Evaluación pre-post de una actividad preventiva de la infección por VIH dirigida a los adolescentes de las comarcas del sur de Tarragona / Pre/post assessment of an HIV infection prevention intervention targeted at teenagers in southern Tarragona

Fundamentos: La infección por el virus de la inmunodeficiencia humana (VIH) es uno de los principales problemas de salud pública que tiene nuestro país. La educación preventiva ha demostrado ser un instrumento útil en la disminución de la enfermedad. El objetivo de este trabajo es evaluar la efectividad de una intervención preventiva realizada en los Institutos de Enseñanza Secundaria (IES) de las comarcas del Baix Ebre y el Montsià correspondientes a la Región Sanitaria de Tortosa, orientada a reducir el riesgo de transmisión del VIH y aumentar el conocimiento de dicha enfermedad. Método: Se realizó un estudio de intervención antes-después, sin grupo control. Se invitó a participar a 19 centros docentes, correspondientes a los cursos de 4º de Enseñanza Secundaria Obligatoria y 1º de Bachillerato. La actividad consistía en un taller de 60-90 minutos de duración, adjuntando material didáctico. El instrumento de medida fue un cuestionario. Resultados: Aceptaron participar 12 centros, obteniendo 896 respuestas en el pre-test y 805 respuestas en el post-test. En el 52 por ciento (10/19) de los ítems se observó un incremento, estadísticamente significativo, de las respuestas correctas en el post-test. En 4 de los 5 ítems (80 por ciento) sobre actitudes y en 5 de los 8 (62,5 por ciento) ítems sobre conocimientos generales de la infección se observó, después de la intervención, una mejora estadísticamente significativa. Sólo en 1 de los 6 ítems (16,6 por ciento) sobre los conocimientos en prevención se observó una mejoría estadísticamente significativa. Conclusiones: Las actividades preventivas en forma de talleres participativos son un buen instrumento para aumentar los conocimientos y mejorar las actitudes respecto al VIH/SIDA de los adolescentes que participan. Al no existir tratamiento curativo para esta enfermedad, la prevención desde el ámbito educativo es relevante para frenar el aumento de transmisión del VIH (AU)