Tuberculosis among children in Oslo, Norway, from 1998 to 2009

Abstract

We investigated all confirmed cases of tuberculosis (TB) among children (age < 16 y) in Oslo from 1998 to 2009. The overall incidence rate was 2.6 per 100,000 person-y. All 24 children diagnosed with TB were of non-Western origin, and the overall incidence rate in this group was 8.1 per 100,000 person-y. Among children of Somali origin, the incidence rate was 52.5 per 100,000 person-y. Pulmonary infiltrates (n = 7), hilar lymphadenopathy without infiltrates (n = 7) and lymph node TB in the neck (n = 5) were the most common clinical presentations. However, we also diagnosed TB meningitis, spondylitis, coxitis and pleuritis. None of the children were HIV-infected. Mycobacterium tuberculosis was cultivated in 19 out of 24 cases (79%). Of the 19 culture-positive cases, 13 had been tested with a polymerase chain reaction, of which 7 (54%) were positive. Isolates from 2 patients were resistant to isoniazid, 1 isolate was resistant to streptomycin, and 2 were resistant to both isoniazid and streptomycin. All children were treated according to a directly observed treatment short-course (DOTS) protocol. One child with TB meningitis died. Twenty-one patients finished treatment in Oslo, and all were cured without major sequelae or recurrence. TB among non-Western immigrant children is still a challenge in Norway.