147: Early Results of National Surveillance of Childhood Tuberculosis in Canada

Abstract

There is little detailed epidemiologic and clinical data about tuberculosis (TB) disease in children in Canada. To characterize the epidemiologic, clinical, and treatment data for all cases of TB in children under age 15 in Canada through the Canadian Pediatric Surveillance Program's (CPSP) Childhood Tuberculosis Study. The initial results of the three year study presented here includes cases from September 2013 to October 2014. TB cases were identified through a monthly form sent by the CPSP to approximately 2500 active pediatricians, pediatric subspecialists, and select non-pediatricians who manage childhood TB. For cases meeting inclusion criteria, a detailed questionnaire was sent to collect clinical, epidemiological, and treatment data, followed by 6-month follow-up surveys until six months after treatment completion. Of 70 unique incident cases reported, 34 cases both met inclusion criteria and returned a detailed questionnaire. Selected demographic data is shown in Table 1. Intrathoracic TB was reported in 32/34 (94%) of cases including 26 with pulmonary infection. One or more positive cultures were obtained in 13/27 (48%) of cases attempting pulmonary culture using sputum (n=7), bronchoalveolar lavage (n=1), and/or gastric aspirates (n=6). Of these, 4/12 (33%) were positive in patients younger than 5 years, 2/6 (33%) between ages 5–9, and 7/9 (78%) children 10+ years. No culture-negative specimen had a positive AFB, PCR, or AMTD. Extrathoracic TB was reported in 27% (n=9). Of these, seven cases had central nervous system involvement. One case had confirmed drug resistance to Isoniazid and Rifampicin. Numerous cases of childhood TB in Canada have been identified through early results from the CPSP Childhood Tuberculosis Study and detailed clinical, epidemiological, and treatment data have been obtained on these cases. This study will provide the most complete picture of childhood TB in Canada and will serve to refine practice in monitoring, detecting, and treating this infection.