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Tuberculosis in Children who Had Contact with TB --- a Preliminary Evaluation of a National LTBI Program in Taiwan 疾病管制局 第三組 Nov. 2009.

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Presentation on theme: "Tuberculosis in Children who Had Contact with TB --- a Preliminary Evaluation of a National LTBI Program in Taiwan 疾病管制局 第三組 Nov. 2009."— Presentation transcript:

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2 Tuberculosis in Children who Had Contact with TB --- a Preliminary Evaluation of a National LTBI Program in Taiwan 疾病管制局 第三組 Nov. 2009

3 Background Contact tracing program in Taiwan has been strengthened through free-charge policy to all close contacts of confirmed tuberculosis (TB) cases since 2007, July. Latent TB infection (LTBI) Treatment has been provided to children contacts aged 12 years or younger through directly observed preventive therapy (DOPT) since 2008, April.

4 Methods Contact aged 12 years and younger registered and had at least one TST result during Apr. 1, 2008~ May, 30, 2009, 14 months. The data was obtained from the National Surveillance Network of Communicable Disease (NSNCD), Centers for Disease Control, Taiwan. All contacts were followed-up until Oct, 7, Not analysis if the index case was excluded.

5 Results A total of 6145 closed contacts aged 12 or younger were followed up 4917 (84%) contacts had very contagious index Index of 5861 contacts are pulmonary TB 0~4 year: 27% 5~9 year: 46% 10~12 year: 27% 1369(28%) TST>=10mm3548 (72%) TST<10mm 857(62.6%) LTBI treatment 512(37%) no LTBI treatment 1845(52%) 2nd TST 1703(48%) no 2nd TST 478 (13.5%) received prophylaxis 17 prophylaxis already 1686(99%) no further manage 450 (24.4%) conversion 196 start LTBI (10 DC, 4 refused, 2 INH R) 123 already prophylaxis (13 DC, 5 were INH R, 4 AE) 131 no further manage (29%) 1395(75.6%) no conversion 21 start tx (12 then DC) 338 already prophylaxis (327 then DC) (90% on DOPT)

6 Those Who Developed TB There were 31 children reported to TCDC in contacts as TB and 16 children were confirmed to be TB: age 7M~12Y, median 8.5Y, 6 bacteriology proved, 14 PTB, 2EPTB (one mediastinal only, one neck + mediastinal)

7 6 The Distribution of Those with TB Diagnosis 1369(28%) TST>=10mm3548 (72%) TST<10mm 857(62.6%) LTBI treatment 512(37%) no LTBI treatment 1845(52%) 2nd TST 1703(48%) no 2nd TST 478 (13.5%) received prophylaxis 17 prophylaxis already 1686(99%) no further manage 450 (24.4%) conversion 196 start LTBI (10 DC, 4 refused, 2 INH R) 123 already prophylaxis (13 DC, 5 were INH R, 4 AE) 131 no further manage (29%) 1395(75.6%) no conversion 21 start tx (12 then DC) 338 already prophylaxis (327 then DC) (90% on DOPT) 3 2 (1*) 8 (4 susp. During contact tracing, 1*) 2 1 (1*)

8 If They Received LTBI Treatment Early The incidence rate of 1379~1562 per person in those TST (+) but who did not received LTBI. Overall, six~seven episodes of tuberculosis (38~44%) might be preventable through prophylaxis/LTBI treatment program.

9 Conclusions LTBI treatment is recommended for all contact children of contagious pulmonary TB. Diagnosis and treatment of LTBI has been improving through this national LTBI program. This preliminary analysis demonstrated that up to 44% of TB cases in children contacts could be prevented if treatment was provided in time.


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