Contact Investigation in Children Exposed to Adult with Pulmonary Tuberculosis - วัณโรคที่สัมผัสในเด็กร่วมบ้านกับคนไข้วัณโรคปอดระยะแพร่เชื้อ

Abstract

Children, particulary young infants, should receive high priority during contact investigations
because the risk of infection is high and they are more likely to rapidly develop severe forms of
tuberculosis. Tubercle bacilli are sparse in the endobronchial secretions of children with pulmonary
tuberculosis, and cough is often absent or lacks the tussis force, so less secretions and opportunity
for laboratory confirmed diagnosis. Clinical diagnosis required; abormal physical examination, chest
radiograph compatible with tuberculosis, positive tuberculin skin test, history of closed contact with
an adult suspected of having infectious pulmonary tuberculosis,and differentiated from other similar
diseases. Using 3 evidence “Triad” is sufficient for provisional diagnosis and treatment. Definite
diagnosis is isolation of Mycobacterium tuberculosis in cultured specimens. Other methods are not
currently used in general. This study was a retrospective study designed to review out patients
medical records of children aged 0-14 years old who had close contact with an adult suspected of
having infectious pulmonary tuberculosis in Ban Pong Hospital from October 2551 to September
2554, ‘Triad’ was used for diagnosis. The objective of this study was to determine the incidence and
treatment outcome of tuberculosis and latent tuberculosis infection. Based on 173 contact cases, the
incidence of pulmonary tuberculosis was 8.67 percent (15 cases), Latent tuberculosis infection was
33.52 percent (58 cases). Sucessful treatment of pulmonary tuberculosis was 92.30 percent (12
cases) and 66.67 percent of latent tuberculosis infection. The highest priority of any tuberculosis
control program should be case, finding and treatment, which interrupts transmission of of infection
between close contacts. ‘Traid can make the diagnosis of tuberculosis in children more easily. Early
treatment of tuberculosis in children, before the disease is progressived should decrease morbidity
and mortality of tuberculosis.
Key words: contact investigation, “Triad”, tuberculosis, latent tuberculosis in children