Featured Research

from universities, journals, and other organizations

Doctors Call For Change In How Non-active TB In Immigrant Children Treated

Date:
March 2, 2009
Source:
Indiana University
Summary:
New guidelines proposed in the March 2009 issue of Pediatrics may have a major impact on how US pediatricians and family physicians treat non-active tuberculosis in children who are immigrants, internationally adopted or refugees. The researchers say the strategy should improve the health of this growing number of children and save health care dollars.

New guidelines proposed in the March 2009 issue of the journal Pediatrics by researchers from the Indiana University School of Medicine and Riley Hospital for Children may have a major impact on how U.S. pediatricians and family physicians treat non-active tuberculosis (TB) in children who are immigrants, internationally adopted or refugees. The researchers say the strategy should improve the health of this growing number of children and save healthcare dollars.

An estimated one-third of the world's men, women and children have TB. Most cases are non-active ones (also called latent) in which individuals have the TB bacteria in their body but their immune system keeps it in check. While they are not actively sick they are at risk of developing active TB and spreading the disease.

Young children under age 5 with non-active TB have a higher rate of developing the active disease than adults. Estimates indicate that between 10 percent and 20 percent of these children will go on to develop active TB. To prevent this from happening, children with latent TB are treated with medication.

"As a pediatrician in the International Adoption Clinic at Riley Hospital, I see patients with non-active TB on a daily basis. These children come from around the world, many from Russia and other countries of the former Soviet Union, China and Vietnam. The children have often lived in crowded conditions in orphanages -- the type of setting where TB is especially common. These are also among the countries where many TB cases have become resistant to the drug isoniazid. Yet standard U.S. treatment guidelines call for us to use this drug for all latent TB infections in children," said Maria Finnell, M.D., first author of the study.

Using sophisticated computer modeling, Dr. Finnell, who is a pediatrics fellow, and her Riley Hospital co-authors John C. Christenson, M.D., IU School of Medicine professor of clinical pediatrics and an infectious disease specialist, and Stephen M. Downs, M.D., IU School of Medicine associate professor of pediatrics and a Regenstrief Institute affiliated scientist, determined that treatment guidelines need to be changed so that children with non-active TB who come to the U.S. from countries with high rates of isoniazid resistance are treated with another drug called rifampin. Rifampin currently is used only in children exposed to known cases of isoniazid resistant TB.

"As we can't find the actual bacteria in patients with non-active TB, we have no way of knowing which children have the isoniazid-resistant strain. Our analysis shows that for those with latent TB who come from countries with isoniazid-resistant rates above 11 percent, treatment with rifampin would be cost-effective. Even though rifampin is a more expensive drug than isoniazid, we would lower total costs because using rifampin would prevent more cases of active TB. As an added benefit, the course of rifampin is six months rather than the nine months of therapy required for isoniazid, which may improve adherence. In parts of the world, more than 40 percent of the active TB cases are now isoniazid resistant. We need to consider where a child came from, what the rate of resistance is in that country, and tailor the medication to that," said Dr. Finnell.

According to Dr. Finnell, there has been no previous analysis of this type for pediatric non-active TB patients, although similar analyses have been done for adults. And she notes that the benefits of treating non-active TB far exceed the minimal risk of side effect in children.

The study was funded by the IU School of Medicine.


Story Source:

The above story is based on materials provided by Indiana University. Note: Materials may be edited for content and length.


Cite This Page:

Indiana University. "Doctors Call For Change In How Non-active TB In Immigrant Children Treated." ScienceDaily. ScienceDaily, 2 March 2009. <www.sciencedaily.com/releases/2009/03/090302120110.htm>.
Indiana University. (2009, March 2). Doctors Call For Change In How Non-active TB In Immigrant Children Treated. ScienceDaily. Retrieved April 16, 2014 from www.sciencedaily.com/releases/2009/03/090302120110.htm
Indiana University. "Doctors Call For Change In How Non-active TB In Immigrant Children Treated." ScienceDaily. www.sciencedaily.com/releases/2009/03/090302120110.htm (accessed April 16, 2014).

Share This



More Health & Medicine News

Wednesday, April 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Outbreak Now Linked To 121 Deaths

Ebola Outbreak Now Linked To 121 Deaths

Newsy (Apr. 15, 2014) The ebola virus outbreak in West Africa is now linked to 121 deaths. Health officials fear the virus will continue to spread in urban areas. Video provided by Newsy
Powered by NewsLook.com
Cognitive Function: Is It All Downhill From Age 24?

Cognitive Function: Is It All Downhill From Age 24?

Newsy (Apr. 15, 2014) A new study out of Canada says cognitive motor performance begins deteriorating around age 24. Video provided by Newsy
Powered by NewsLook.com
How Mt. Everest Helped Scientists Research Diabetes

How Mt. Everest Helped Scientists Research Diabetes

Newsy (Apr. 15, 2014) British researchers were able to use Mount Everest's low altitudes to study insulin resistance. They hope to find ways to treat diabetes. Video provided by Newsy
Powered by NewsLook.com
Carpenter's Injury Leads To Hundreds Of 3-D-Printed Hands

Carpenter's Injury Leads To Hundreds Of 3-D-Printed Hands

Newsy (Apr. 14, 2014) Richard van As lost all fingers on his right hand in a woodworking accident. Now, he's used the incident to create a prosthetic to help hundreds. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins