International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Seminar Infection Diseases in Arctic

Objectives: To estimate the level of ongoing TB transmission in East Greenland by assessing the prevalence of TB infection in children and adolescence by conventional tuberculin skin testing (TST) and by a new blood test (QuantiFERON TB-Gold®)(QF-TB) specific for M tuberculosis infection. The result was associated with recognized and less well- described risk factors like nutritional status. To assess the performance of QF-TB in children < 17 years.

Material and Methods: A cross-sectional study, inviting all school children aged 6 to 18 years attending the municipal school in the town of Tasiilaq (n= 406) and in the village Kuumiut (n = 86), Ammassalik, East Greenland All participants answered a questionnaire regarding basic demographic information, standard of housing, health conditions and previous exposure to TB. A TST and a QF-TB was performed. In order to identify children with pre-metabolic syndrome, body mass index (BMI) and waist circumference was measured.

Results: A total of 445 school children participated (90%). In total 42% of the children were BCG vaccinated.394(89%) children returned for TST reading, and 43 (11%) turned out positive. 32 of 443 (7%) were QF-TB positive. One child had a negative TST but a positive QF-TB.28 (65%) of the TST positive were prior BCG vaccinated as were 21 (65%) of the QF-TB positive. 9 (2%) of the QF-TB test-results were indeterminate 37 of the 43(86%) TST positive children and 26 of the 32 (81%) QF-TB positive children had previously been treated for latent (LTBI) or active TB infection. These children are now receiving clinical follow-up. Examination of children with positive TST or QF-TB test- results, and no information on prior treatment, revealed two children with active TB disease. Three children were found latently infected and offered prophylactic treatment. One is pregnant and awaiting x-ray.Results obtained from riskfactor analysis will be presented.

Conclusion: The prevalence of TB infection among children is a strong indicator of active TB transmission in a society. Despite an increased awareness during recent years in Greenland and a voluntary TST survey among the population of Tasiilaq in 2003, this study indicates that TB transmission is still ongoing. A prevalence of 7% measured by the QF-TB is higher than any prevalence reported from the 22 high-burden countries in the world. Apparently micro hyper- and hypo endemic regions may be identified within geographical entities of Greenland as no children from the rather isolated village, Kuumiut, were infected. The QF-TB proved useful in children and adolescence < 17 as only 2% of the tests was indeterminate. By using QF-TB as the primary screening tool the LTBI prevalence can be reduced from 11% to 7 % , hereby reducing cost and hopefully improve contact- and case-finding.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)