{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T16:13:29Z","timestamp":1757780009973,"version":"3.40.5"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>To describe the epidemiology and factors associated with pediatric central nervous system (CNS) tuberculosis (TB) in California from 1993 to 2011.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We analyzed California TB registry data for persons aged \u226418 years, comparing CNS TB cases versus non-CNS TB cases reported from 1993 to 2011. Factors associated with CNS TB and TB deaths were identified by using multivariate logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 200 CNS TB cases were reported. Compared with non-CNS TB case patients, CNS TB case patients were more likely to be aged &amp;lt;5 years (72.0% vs 43.6%; odds ratio [OR]: 3.8 [95% confidence interval (CI): 2.4\u20135.9]), US-born (82.0% vs 58.2%; OR: 3.3 [CI: 2.3\u20134.7]), and Hispanic (75.0% vs 63.2%; OR: 1.7 [CI: 1.3\u20132.4]). Among US-born CNS TB case patients (during 2010\u20132011), 76.5% had a foreign-born parent. Tuberculin skin test results were negative in 38.2% of 170 CNS TB cases tested. In multivariate analysis, age &amp;lt;5 years (adjusted odds ratio [aOR]: 3.3 [CI: 2.0\u20135.4]), US birth (aOR: 1.8 [CI 1.2\u20132.7]), and Hispanic ethnicity (aOR: 1.5 [CI: 1.1\u20132.1]) were associated with an increased risk of developing CNS TB. For deaths, CNS TB (aOR: 3.8 [CI: 1.4\u20139.9]) and culture positivity (aOR: 6.2 [CI: 2.2\u201317.3]) were associated with increased risk of death, whereas tuberculin skin test positivity (aOR: 0.1 [CI: 0.04\u20130.2]) was associated with decreased risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Subsets of children are at increased risk for CNS TB in California and may benefit from additional prevention efforts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-3958","type":"journal-article","created":{"date-parts":[[2015,10,6]],"date-time":"2015-10-06T00:38:31Z","timestamp":1444091911000},"page":"e1276-e1284","source":"Crossref","is-referenced-by-count":17,"title":["Risk Factors for Central Nervous System Tuberculosis"],"prefix":"10.1542","volume":"136","author":[{"given":"Alexandra","family":"Duque-Silva","sequence":"first","affiliation":[{"name":"UCSF Benioff Children\u2019s Hospital Oakland, Oakland, California; and"},{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Robsky","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Flood","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pennan M.","family":"Barry","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2015,11,1]]},"reference":[{"issue":"10","key":"2021120906105141100_B1","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/S1473-3099(14)70852-7","article-title":"Treatment outcomes of childhood tuberculous meningitis: a systematic review and meta-analysis.","volume":"14","author":"Chiang","year":"2014","journal-title":"Lancet Infect Dis"},{"issue":"2","key":"2021120906105141100_B2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1542\/peds.114.2.333","article-title":"Epidemiology of childhood tuberculosis in the United States, 1993\u20132001: the need for continued vigilance.","volume":"114","author":"Nelson","year":"2004","journal-title":"Pediatrics"},{"issue":"5","key":"2021120906105141100_B3","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/00006454-199805000-00012","article-title":"Tuberculosis in children and adolescents: California, 1985 to 1995.","volume":"17","author":"Lobato","year":"1998","journal-title":"Pediatr Infect Dis J"},{"issue":"6","key":"2021120906105141100_B4","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1164\/ajrccm.158.6.9804106","article-title":"Mycobacterium tuberculosis infection after travel to or contact with visitors from countries with a high prevalence of tuberculosis.","volume":"158","author":"Lobato","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"2021120906105141100_B5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1053\/j.spid.2004.05.007","article-title":"Tuberculosis in children: considerations for children from developing countries.","volume":"15","author":"Nelson","year":"2004","journal-title":"Semin Pediatr Infect Dis"},{"issue":"1","key":"2021120906105141100_B6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.104.1.e8","article-title":"Immigration and tuberculosis among children on the United States-Mexico border, county of San Diego, California.","volume":"104","author":"Kenyon","year":"1999","journal-title":"Pediatrics"},{"issue":"2","key":"2021120906105141100_B7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1128\/CMR.00042-07","article-title":"Central nervous system tuberculosis: pathogenesis and clinical aspects.","volume":"21","author":"Rock","year":"2008","journal-title":"Clin Microbiol Rev"},{"issue":"5","key":"2021120906105141100_B8","first-page":"636","article-title":"Global epidemiology of childhood tuberculosis.","volume":"8","author":"Nelson","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2021120906105141100_B9","first-page":"1","article-title":"The role of BCG vaccine in the prevention and control of tuberculosis in the United States. 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