Purchase, Susan E;
Brigden, Joanna;
Seddon, James A;
Martinson, Neil A;
Fairlie, Lee;
Staples, Suzanne;
Wilkinson, Thomas;
... Hesseling, Anneke C; + view all
(2025)
Risk of Tuberculosis Infection in Young Children Exposed to Multidrug-resistant Tuberculosis in the TB-CHAMP Multi-site Randomized Controlled Trial.
Clinical Infectious Diseases
, Article ciaf284. 10.1093/cid/ciaf284.
(In press).
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Abstract
Background: Young children have a high risk of developing tuberculosis (TB) disease following infection with Mycobacterium tuberculosis in the absence of preventive treatment. Infection prevalence and risk factors for infection impact delivery of prevention strategies. We aimed to determine the prevalence of infection in child household contacts aged <5 years exposed to adults with confirmed pulmonary multidrug-resistant (MDR)-TB and to determine risk factors for infection. // Methods: TB-CHAMP was a trial of MDR-TB prevention that recruited children younger than age 5 years, regardless of M. tuberculosis infection status. All children enrolled had an interferon-gamma release assay (IGRA) at baseline. We described M. tuberculosis infection prevalence, developed directed acyclic graphs to clarify causal relationships, and used modified Poisson regression models to assess the relationship between risk factors and IGRA positivity. // Results: Of 785 included children, 160 (20.4%) had a positive IGRA. Duration of cough and drug misuse in the index patient, age of the child, relationship between the child and the index patient, and study site were significantly associated with risk of infection. // Conclusions: The prevalence of infection was lower than observed in previous studies. This may be related to improved diagnosis and treatment of MDR-TB in the study setting and/or test limitations and has implications for TB preventive treatment. When considering TB preventive treatment for child contacts, healthcare providers should be especially concerned about any young child exposed to an adult index patient who is his/her parent/primary caregiver, has a chronic cough, and/or a history of drug misuse.
| Type: | Article |
|---|---|
| Title: | Risk of Tuberculosis Infection in Young Children Exposed to Multidrug-resistant Tuberculosis in the TB-CHAMP Multi-site Randomized Controlled Trial |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/cid/ciaf284 |
| Publisher version: | https://doi.org/10.1093/cid/ciaf284 |
| Language: | English |
| Additional information: | Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
| Keywords: | Levofloxacin, risk factors, interferon-gamma release assays, preventive treatment, directed acyclic graphs, Poisson regression |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10210404 |
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