Childhood tuberculosis in a low-income Paris suburb: lessons from a resurgence brought under control.
METHODS
Few series of paediatric tuberculosis (TB) have been reported in the last 20 years.


OBJECTIVE
To describe diagnostic and treatment practices in children with TB living in Seine-Saint-Denis, a low-income Paris suburb.


METHODS
Local TB incidence in 1998 was 34.2/100,000 overall and 10.2/100,000 in children. Between September 1996 and December 1997, the hospitals and prevention units serving the area's paediatric population were sent questionnaires to identify TB cases in children aged under 15 living in Seine-Saint-Denis and treated with at least one anti-tuberculosis drug.


RESULTS
Of 92 cases identified, 60 (65%) had been diagnosed during contact tracing; for 52 patients (60%), the index case had been found. The reason for anti-tuberculosis treatment was active TB in 26 (28.3%), latent TB in 46 (50%), and prophylaxis in 20 (21.8%). Forty per cent (37/92) of the patients were aged under 5. Only 15 of the 35 notified cases met the criteria for mandatory notification (at least three anti-tuberculosis drugs).


CONCLUSIONS
TB remains a public health problem in Seine-Saint-Denis. The high proportion of cases identified by contact tracing attests to the efficacy of the local contact-tracing programme. The criteria for mandatory notification in France were too restrictive to ensure effective surveillance of childhood TB. Since 2002, notification has included cases of tuberculous infection in children.
de Pontual
L
L
Department of Paediatrics, Jean Verdier Teaching Hospital, Bondy, France. loic.de-pontual@jvr.ap-hop-paris.fr
Hollebecque
V
V
Bessa
Z
Z
Camard
O
O
Lachassine
E
E
Muller
M-H
MH
Gaudelus
J
J
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D018563:Disease Notification; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010297:Paris / Q000453:epidemiology; D011204:Poverty Areas; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology
D000995:Antitubercular Agents