Abstract

Aim:
Pediatric Tuberculosis (TB) infection rates have declined during the last decade in the U.S. Among infants, 0-2 years of age, TB may be difficult to detect. Our study examined the epidemiology of active TB infection to determine case rates specifically in this population. Methods: Demographic data for Pediatric patients was analyzed from the United States National TB surveillance system (NTSS). The available data for i) 0-2 years and ii) 0-5 years were collected for the years 2000-2018. The case rates per 100,000 children and trends over time were analyzed using descriptive statistical methods. Further analysis of the pediatric cohort included identification of U.S. born ethnic and gender distribution.
Results: Based on our analysis, there is interestingly a lack of data specifically for the 0-2 year age group. There were 186 cases reported for children < 5 years old in 2018. The case rate was 0.9 cases/100,000 in the 0-4 year age group. This cohort represented approximately 2.1% of all TB cases in the U.S in 2018.
The trend plot for 2000-2018 showed consistently decreasing case rates. The case rate was higher among females (n=105) and among U.S .born children, ethnic minorities accounted for most of the cases.
Conclusions:
There is a need to further characterize Pediatric TB among the infant population. The frequency of other LTRI e.g. RSV is well described in contrast. This highlights the difficulty of diagnosis among this age group, during a time of lung and immunologic development and susceptibility to respiratory infections.
The case rate for TB for the 0-4 year age group shows a decline overall from 2000-2018, but among U.S. born children is more common among ethnic minorities.