open access

Vol 86, No 3 (2018)
GUIDELINES
Published online: 2018-06-30
Submitted: 2018-03-12
Accepted: 2018-06-20
Get Citation

Recommendations for the management of tuberculosis in children — KOMPASS TB. Part 1: Tuberculosis prevention

Teresa Bielecka, Ewa Augustynowicz-Kopeć, Paweł Gonerko, Paweł Gruszczyński, Maria Korzeniewska-Koseła, Maria Krasińska, Katarzyna Krenke, Joanna Lange, Anna Pankowska, Marek Popielarz, Andrzej Pustkowski, Joanna Stryczyńska-Kazubska, Zbigniew Doniec
DOI: 10.5603/ARM.2018.0023
·
Adv Respir Med 2018;86(3):149-157.

open access

Vol 86, No 3 (2018)
GUIDELINES
Published online: 2018-06-30
Submitted: 2018-03-12
Accepted: 2018-06-20

Abstract

Since the second half of the 20th century the incidence of tuberculosis has been declining in Poland. Despite this, current epidemiological data still support the need for the continued mass BCG vaccination in Poland in the near future. Apart from the protection against severe hematogenous forms of tuberculosis, vaccination lowers the risk of infection with Mycobacterium tuberculosis. Primary and acquired immunodeficiency, including immunity disorders associated with an ongoing treatment, are contraindications to BCG vaccination. The most common adverse effects following BCG vaccination are reactions at the site of injection and in regional lymph nodes, which usually does not require treatment. Methods of tuberculosis prevention, particularly recommended in low-incidence countries, include: diagnostic investigations of patients who had contacts with pulmonary tuberculosis as well as an active detection and treatment of latent Mycobacterium tuberculosis infection. Latent tuberculosis infection can be identified on the basis of positive results of the tuberculin skin test or interferon-gamma release assays after the active disease has been ruled out. This condition does require prophylactic treatment.

Abstract

Since the second half of the 20th century the incidence of tuberculosis has been declining in Poland. Despite this, current epidemiological data still support the need for the continued mass BCG vaccination in Poland in the near future. Apart from the protection against severe hematogenous forms of tuberculosis, vaccination lowers the risk of infection with Mycobacterium tuberculosis. Primary and acquired immunodeficiency, including immunity disorders associated with an ongoing treatment, are contraindications to BCG vaccination. The most common adverse effects following BCG vaccination are reactions at the site of injection and in regional lymph nodes, which usually does not require treatment. Methods of tuberculosis prevention, particularly recommended in low-incidence countries, include: diagnostic investigations of patients who had contacts with pulmonary tuberculosis as well as an active detection and treatment of latent Mycobacterium tuberculosis infection. Latent tuberculosis infection can be identified on the basis of positive results of the tuberculin skin test or interferon-gamma release assays after the active disease has been ruled out. This condition does require prophylactic treatment.

Get Citation

Keywords

BCG vaccination, tuberculosis contact investigation, latent tuberculosis infection

About this article
Title

Recommendations for the management of tuberculosis in children — KOMPASS TB. Part 1: Tuberculosis prevention

Journal

Advances in Respiratory Medicine

Issue

Vol 86, No 3 (2018)

Pages

149-157

Published online

2018-06-30

DOI

10.5603/ARM.2018.0023

Bibliographic record

Adv Respir Med 2018;86(3):149-157.

Keywords

BCG vaccination
tuberculosis contact investigation
latent tuberculosis infection

Authors

Teresa Bielecka
Ewa Augustynowicz-Kopeć
Paweł Gonerko
Paweł Gruszczyński
Maria Korzeniewska-Koseła
Maria Krasińska
Katarzyna Krenke
Joanna Lange
Anna Pankowska
Marek Popielarz
Andrzej Pustkowski
Joanna Stryczyńska-Kazubska
Zbigniew Doniec

References (36)
  1. Korzeniewska-Koseła M. Gruźlica w Polsce w 2016r. Instytut Gruźlicy i Chorób Płuc, Warszawa 2017.
  2. Diel R, Nienhaus A. Prevention of TB in areas of low incidence. Tuberculosis. 2012: 72–83.
  3. Dara M, Acosta CD, Rusovich V, et al. WHO EURO Childhood Task Force members. Bacille Calmette-Guérin vaccination: the current situation in Europe. Eur Respir J. 2014; 43(1): 24–35.
  4. Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet. 2006; 367(9517): 1173–1180.
  5. http://www.who.int/vaccine_safety/initiative/tools/BCG_Vaccine_rates_information_sheet.pdf.
  6. Colditz GA, Berkey CS, Mosteller F, et al. Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature. JAMA. 1994; 271(9): 698–702.
  7. Roy A, Eisenhut M, Harris RJ, et al. Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis. BMJ. 2014; 349: g4643.
  8. Criteria for discontinuation of vaccination programmes using Bacille Calmette-Guerin (BCG) in countries with a low prevalence of tuberculosis. A statement of the International Union Against Tuberculosis and Lung Disease. Tuber Lung Dis. 1994; 75(3): 179–180.
  9. Dziennik Ustaw 2008 nr 234 poz. 1570. http://isap.sejm.gov.pl/DetailsServlet?id=WDU20082341570.
  10. https://baza-lekow.com.pl/szczepionka-przeciwgruzlicza-bcg-10/#CHAR.
  11. https://lekomanprod.blob.core.windows.net/product-documents/doc21971/bcg-szczepionka-ssi-dokument.pdf.
  12. Cheent K, Nolan J, Shariq S, et al. Case Report: Fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn's disease. J Crohns Colitis. 2010; 4(5): 603–605.
  13. Esteve-Solé A, Deyà-Martínez À, Teixidó I, et al. Immunological Changes in Blood of Newborns Exposed to Anti-TNF-α during Pregnancy. Front Immunol. 2017; 8: 1123.
  14. WHO, Guidance for national tuberculosis programmes on the management of tuberculosis in children Second Edition. http://www.who.int/tb/publications/childtb_guidelines/en/.
  15. https://gis.gov.pl/images/pso_2018_r_.pdf.
  16. Roth AE, Benn CS, Ravn H, et al. Effect of revaccination with BCG in early childhood on mortality: randomised trial in Guinea-Bissau. BMJ. 2010; 340: c671.
  17. Pietrucha B, Heropolitańska-Pliszka E, Klaudel-Dreszler M, et al. Wybrane zagadnienia z immunologii klinicznej – niedobory przeciwciał i niedobory komórkowe (część I). Pediatria Polska. 2011; 86(5): 548–558.
  18. Tebruegge M, Buonsenso D, Brinkmann F, et al. Paediatric Tuberculosis Network European Trials Group (ptbnet). Tuberculous dactylitis--an easily missed diagnosis. Eur J Clin Microbiol Infect Dis. 2011; 30(11): 1303–1310.
  19. Oettinger T, Jørgensen M, Ladefoged A, et al. Development of the Mycobacterium bovis BCG vaccine: review of the historical and biochemical evidence for a genealogical tree. Tuber Lung Dis. 1999; 79(4): 243–250.
  20. Venkataraman A, Yusuff M, Liebeschuetz S, et al. Management and outcome of Bacille Calmette-Guérin vaccine adverse reactions. Vaccine. 2015; 33(41): 5470–5474.
  21. Sanders R, Dickson MG. BCG vaccination scars: an avoidable problem? Br Med J (Clin Res Ed). 1982; 285(6356): 1679–1680.
  22. Cuello-García CA, Pérez-Gaxiola G, Jiménez Gutiérrez C. Treating BCG-induced disease in children. Cochrane Database Syst Rev. 2013(1): CD008300.
  23. Pal S, Chakarabarti S, Phukan JP, et al. Role of needle aspiration in diagnosis and management of suppurative bacille calmette-guerin adenitis: an institutional study of 30 cases. J Lab Physicians. 2015; 7(1): 21–25.
  24. Hang WM, Kwan YW, Leung CW. Management of Bacillus Calmette-Guérin Lymphadenitis. HK J Paediatr. 2011; 16: 85–94.
  25. Lin WL, Chiu NC, Lee PH, et al. Management of Bacillus Calmette-Guérin osteomyelitis/osteitis in immunocompetent children-A systematic review. Vaccine. 2015; 33(36): 4391–4397.
  26. Al-Mousa H. An infant with disseminated bacillus Calmette-Guerin infection (BCGitis). International Journal of Pediatrics and Adolescent Medicine. 2014; 1(2): 89–92.
  27. Antaya RJ, Gardner ES, Bettencourt MS, et al. Cutaneous complications of BCG vaccination in infants with immune disorders: two cases and a review of the literature. Pediatr Dermatol. 2001; 18(3): 205–209.
  28. Bernatowska E, Wolska-Kuśnierz B, Pac M, et al. Risk of BCG infection in primary immunodeficiency children. Proposal of diagnostic, prophylactic and therapeutic guidelines for disseminated BCG based on experience in the Department of Immunology, Children’s Memorial Health Institute in Warsaw between 1980-2006. CentrEur J Immunol. 2007; 32: 221–225.
  29. WHO Guidelines on the management of latent tuberculosis infection. WHO/HTM/TB/2015.01. http://www.who.int/tb/publications/ltbi_document_page/en/.
  30. https://www.cdc.gov/tb/publications/ltbi/default.htm.
  31. Kimberlin DW, Brady MT, Jackson MA, Long SS. American Academy of Pediatrics. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Tuberculosis. Elk Grove Village 2015: 805–831.
  32. Toruner M, Loftus EV, Harmsen WS, et al. Risk factors for opportunistic infections in patients with inflammatory bowel disease. Gastroenterology. 2008; 134(4): 929–936.
  33. Erkens CGM, Kamphorst M, Abubakar I, et al. Tuberculosis contact investigation in low prevalence countries: a European consensus. Eur Respir J. 2010; 36(4): 925–949.
  34. Bumbacea D, Arend SM, Eyuboglu F, et al. The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement. Eur Respir J. 2012; 40(4): 990–1013.
  35. Solovic I, Sester M, Gomez-Reino JJ, et al. The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement. Eur Respir J. 2010; 36(5): 1185–1206.
  36. Lancella L, Vecchio A, Chiappini E, et al. How to manage children who have come into contact with patients affected by tuberculosis. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases. 2015; 1: 1–12.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl