Pediatric and adolescent tuberculosis in Latvia, 2011-2014: Case detection, diagnosis and treatment

Objective: To perform a comprehensive analysis of case detection, diagnosis and treatment of tuberculosis (TB) in children and adolescents in Latvia, and to evaluate the utility of the current approach. Design : A retrospective study of all Latvian children and adolescents diagnosed with TB from 1 January 2011 to 31 December 2014. Results : Of 3081 patients diagnosed with TB during 2011-2014, 250 (8%) were aged ,18 years, and 80% were identified through contact investigation. Pulmonary TB was diagnosed in 77% of the patients. TB was confirmed bacteriologically in 21% of patients; chest Xray (CXR) was consistent with TB in 42% of study participants, while 58% of cases were diagnosed with subclinical TB using low-dose computed tomography (CT) after being missed by CXR. Patients with visible abnormalities on CXR had a higher rate of bacteriological confirmation and were more often clinically symptomatic, which indicates active disease. Early diagnosis had a treatment success rate of 100% for drug-resistant and 99% for drug-susceptible TB. conclusion : TB case detection through contact investigation provided early diagnosis and excellent treatment outcomes in children and adolescents in Latvia. CT was able to identify pathology consistent with subclinical TB in children with a history of exposure.