Window Period Prophylaxis for Children Exposed to Tuberculosis, Houston, Texas, USA, 2007-2017

Emerging Infectious Diseases
Andrea T Cruz, Jeffrey R Starke

Abstract

In this retrospective study, we assessed the safety of window period prophylaxis and proportion of tuberculin skin test (TST) conversions in children <5 years of age who were exposed to an adult with tuberculosis disease during 2007-2017. Children included in this study had unremarkable examination and chest radiograph findings and negative test results for TB infection. In total, 752 children (41% cohabitating with the index patient) received prophylaxis during the window period, usually directly observed therapy with isoniazid. Hepatotoxicity and tuberculosis disease did not develop in any child. TST conversion occurred in 37 (4.9%) children and was associated with the index patient being the child's parent (odds ratio 3.2, 95% CI 1.2-8.2). TST conversion was not associated with sputum smear results, culture positivity, or cohabitation. Thresholds for initiation of window prophylaxis in exposed young children should be low given the safety of medication and difficulties with risk stratification.

References

Feb 19, 2008·The Pediatric Infectious Disease Journal·Dwight A PowellNancy Ryan-Wenger
Oct 8, 2011·The Pediatric Infectious Disease Journal·Andrea T Cruz, Jeffrey R Starke
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Jan 16, 2013·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·A T Cruz, J R Starke
Jun 7, 2014·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·M J SaundersM Dedicoat
Jul 27, 2014·The European Respiratory Journal·Rosa SlootMartien W Borgdorff
Nov 8, 2017·The Journal of Infectious Diseases·Richard D TurnerKevin P Fennelly
Jan 25, 2018·Pediatrics·Andrea T Cruz, Jeffrey R Starke
Mar 23, 2018·MMWR. Morbidity and Mortality Weekly Report·Rebekah J StewartAdam J Langer
Aug 2, 2018·The New England Journal of Medicine·Thierno DialloDick Menzies
Aug 11, 2018·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·P R DonaldE Nardell
Sep 19, 2018·Emerging Infectious Diseases·Richard S GarfeinFredric Raab

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Citations

Aug 18, 2020·The Pediatric Infectious Disease Journal·James GaensbauerMichelle K Haas

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