{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:53:35Z","timestamp":1789181615669,"version":"build-2803163510"},"reference-count":26,"publisher":"BMJ","issue":"7","funder":[{"name":"M\u00e9decins Sans Fronti\u00e8res- France"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to measure the prevalence and incidence of latent tuberculosis infection (LTBI) and tuberculosis (TB) disease in children in close contact with patients with drug-resistant TB (DR-TB) in a country with high DR-TB prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>This is a prospective cohort study of paediatric contacts of adult patients with pulmonary DR-TB in Armenia. Children were screened using tuberculin skin test, interferon-gamma release assay and chest X-ray at the initial consultation, and were reassessed every 3\u20136 months for a period of 24 months. Children did not receive preventive treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Prevalence and incidence of LTBI and TB disease; factors associated with prevalent LTBI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At initial evaluation, 3 of the 150 children included were diagnosed with TB disease (2.0%). The prevalence of LTBI was 58.7%. The incidence of LTBI was 19.9 per 100 children per year, and was especially high during the first 6\u2009months of follow-up (33.3 per 100 children per year). No additional cases with incident disease were diagnosed during follow-up. After adjustment, prevalent LTBI was significantly associated with the child\u2019s age, sleeping in the same house, higher household density, the index case\u2019s age, positive smear result and presence of lung cavities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Children in close contact with patients with DR-TB or in contact with very contagious patients had an increased risk of prevalent LTBI. Although none of the children developed TB disease during a 2-year follow-up period, screening for symptoms of TB disease, based on the prevalence of disease at recruitment, together with follow-up and repeated testing of non-infected contacts, is highly recommended in paediatric contacts of patients with DR-TB.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2018-315411","type":"journal-article","created":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T22:26:42Z","timestamp":1544135202000},"page":"622-628","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["High prevalence of infection and low incidence of disease in child contacts of patients with drug-resistant tuberculosis: a prospective cohort study"],"prefix":"10.1136","volume":"104","author":[{"given":"Helena","family":"Huerga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Sanchez-Padilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nara","family":"Melikyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakob","family":"Atshemyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armen","family":"Hayrapetyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ani","family":"Ulumyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Bastard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naira","family":"Khachatryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hewison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Varaine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryline","family":"Bonnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,12,6]]},"reference":[{"key":"2020050712494633000_104.7.622.1","unstructured":"World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva 2018."},{"key":"2020050712494633000_104.7.622.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30418-2"},{"key":"2020050712494633000_104.7.622.3","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/s41426-018-0101-6","article-title":"Have compensatory mutations facilitated the current epidemic of multidrug-resistant tuberculosis?","volume":"7","author":"Liu","year":"2018","journal-title":"Emerg Microbes Infect"},{"key":"2020050712494633000_104.7.622.4","doi-asserted-by":"publisher","DOI":"10.1038\/nm1102"},{"key":"2020050712494633000_104.7.622.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.5.765"},{"key":"2020050712494633000_104.7.622.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit655"},{"key":"2020050712494633000_104.7.622.7","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0593"},{"key":"2020050712494633000_104.7.622.8","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31826f6063"},{"key":"2020050712494633000_104.7.622.9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-392"},{"key":"2020050712494633000_104.7.622.10","doi-asserted-by":"crossref","first-page":"515","DOI":"10.5588\/ijtld.13.0840","article-title":"Latent tuberculous infection prevalence among paediatric contacts of drug-resistant and drug-susceptible cases","volume":"18","author":"Laniado-Labor\u00edn","year":"2014","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050712494633000_104.7.622.11","first-page":"S494","article-title":"Tuberculosis infection and disease in children living in households of Filipino patients with tuberculosis: a preliminary report","volume":"7","author":"Salazar-Vergara","year":"2003","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050712494633000_104.7.622.12","unstructured":"World Health Organization. Global Tuberculosis Report. Geneva: World Health Organization, 2017."},{"key":"2020050712494633000_104.7.622.13","unstructured":"Handbook for district hospitals in resource constrained setings on quality assurance of chest radiography: for better TB control and health system strengthening. http:\/\/www.tbcare1.org\/publications\/toolbox\/tools\/access\/XRayQAHandbook.pdf (Accessed 15 Dec 2017)."},{"key":"2020050712494633000_104.7.622.14","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis008"},{"key":"2020050712494633000_104.7.622.15","unstructured":"Mendrekar JN , Mandrekar SJ , Cha SS . Cutpoint Determination Methods in Survival Analysis Using SAS. Stat Data Anal 2002:1\u20135."},{"key":"2020050712494633000_104.7.622.16","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"2020050712494633000_104.7.622.17","first-page":"286","article-title":"The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals","volume":"8","author":"Cegielski","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050712494633000_104.7.622.18","unstructured":"Marais BJ , Gie RP , Schaaf HS , et al . The clinical epidemiology of childhood pulmonary tuberculosis : a critical review of literature from the pre-chemotherapy era. 2004;8:278\u201385."},{"key":"2020050712494633000_104.7.622.19","unstructured":"UNAIDS\/WHO Epidemiological Fact Sheet: Armenia- 2016 Update. http:\/\/www.unaids.org\/en\/regionscountries\/countries\/armenia (Accessed 13 Dec 2017)."},{"key":"2020050712494633000_104.7.622.20","first-page":"392","article-title":"The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era","volume":"8","author":"Marais","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050712494633000_104.7.622.21","doi-asserted-by":"publisher","DOI":"10.1086\/379895"},{"key":"2020050712494633000_104.7.622.22","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1186\/s12879-017-2668-2","article-title":"The impact of drug resistance on the risk of tuberculosis infection and disease in child household contacts: a cross sectional study","volume":"17","author":"Golla","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2020050712494633000_104.7.622.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.tig.2012.11.005"},{"key":"2020050712494633000_104.7.622.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.02182.x"},{"key":"2020050712494633000_104.7.622.25","doi-asserted-by":"crossref","unstructured":"Grandjean L , Gilman RH , Martin L , et al . Transmission of multidrug-resistant and drug-susceptible tuberculosis within households: a prospective cohort study. PLoS Med 2015;12:e1001843.doi:10.1371\/journal.pmed.1001843","DOI":"10.1371\/journal.pmed.1001843"},{"key":"2020050712494633000_104.7.622.26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1405427"}],"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2018-315411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T22:14:06Z","timestamp":1601072046000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2018-315411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,6]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,6,19]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/archdischild-2018-315411"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2018-315411","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,6]]}}}