The 130th Annual Meeting of APHA

Abstract #47596

Roberta Laguerre, MD¹, Dana Perella, BS², Elizabeth Oppenheim², Dagna Laufer, MD³, Barbara Watson, MD⁴, and P.J. Brennan, MD, MPH⁵. (1) Philadelphia Department of Public Health/Albert Einstein Medical Center, 500 S. Broad St., 2nd Flr., Philadelphia, PA 19146, 215-456-6595, laguerre213@cs.com, (2) Division of Disease Control, Philadelphia Department of Public Health, 500 S. Broad St., 2nd Flr., Philadelphia, PA 19146, (3) Philadelphia Department of Public Health/Wyeth-Ayerst Global Pharmaceuticals, 500 S. Broad St., 2nd Flr., Philadelphia, PA 19146, (4) Divison of Disease Control, Philadelphia Department of Public Health, 500 S. Broad Street, Philadelphia, PA 19146, (5) TB Control Program, Philadelphia Department of Public Health, 500 S. Broad St., 2nd Flr., Philadelphia, PA 19146

Background: The Philadelphia Department of Public Health's (PDPH) TB Control Program, which provides preventive and treatment services to Philadelphia residents, has observed confusion exists among pediatric healthcare providers regarding appropriate TB screening procedures posing a significant barrier to disease control.

Objective: To establish useful guidelines for appropriate screening and detection of pediatric TB cases.

Methods: Demographic, exposure, and clinical information were collected during a retrospective chart review of pediatric TB cases reported to PDPH from 1994 to 2000.

Results: From January 1, 1994 to December 31, 2000, 134 pediatric TB cases 16 years of age or younger from Philadelphia were reported to PDPH. TB tests were placed for exposures, symptoms, or routine screenings in 33.6%, 29.1%, and 34.3% of the cases, respectively. There were slightly more male cases than females with 7.5% of the cases less than 1 year of age. One-quarter of the cases (24.6%) were foreign born, and 38.8% had foreign-born parents. Asthma was noted in 13 of the 27 (48.1%) TB cases with comorbid conditions. Almost half of the cases (49.3%) were asymptomatic. Exposure sources were identified in 56.0% of the cases with the case's mother being the most common source. Twenty-four of the 63 pediatric cases (38.1%) with exposure source report dates available were identified within 90 days of their source case.

Conclusions: Few new risk factors were identified; however, this review clarified that timely and consistent evaluation of previously established common risk factors would increase early detection and intervention for pediatric TB cases.

Learning Objectives:

• Identify common risk factors for pediatric TB.
• Understand the importance of contact investigations.
• More appropriately screen for pediatric TB.

Keywords: Screening, TB

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.