title: Trends in the epidemiology of childhood tuberculosis in Greece.
abstract: METHODS
  A hospital referral center for childhood tuberculosis (TB).
  
  
  OBJECTIVE
  To evaluate the epidemiological and clinical features of childhood TB in the Greater Athens area in the last decade.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients aged <14  years treated for active TB between January 2000 and December 2009 at our pediatric TB clinic and compared the results with the patient turnover during the previous decade (1990-1999). Data concerning demographic and clinical characteristics were analyzed.
  
  
  RESULTS
  A total of 321  children (median age 5.57 years, 157 males) with active TB were identified. About one third originated from areas where TB was previously recognized to be highly endemic. Twenty-three children (7%) had extra-pulmonary TB, and 61% of them originated from TB-endemic areas. Bacteriological confirmation  was obtained in 40% of patients from whom specimens were obtained: 1 of 26 (3.8%) strains was multidrug-resistant. Most cases with drug-resistant Mycobacterium tuberculosis were noted among immigrant children. The average annual TB incidence was estimated at 5.37 per 100 000  for children aged <14 years in the Greater Athens area. Time trend analysis for the 20-year period revealed a significant reduction in the total number of TB cases (P = 0.002) and in TB among children from low-incidence countries (P < 0.0001).
  
  
  CONCLUSIONS
  In our settings,  active TB is decreasing among children of Greek origin; disease epidemiology and drug resistance is influenced by the increasing influx of immigrants from areas where the disease is highly prevalent.
authors.affiliation: Second Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece. lia_syridou@yahoo.com
authors.forename: G
authors.initials: G
authors.lastname: Syridou
authors.forename: M
authors.initials: M
authors.lastname: Mavrikou
authors.forename: V
authors.initials: V
authors.lastname: Amanatidou
authors.forename: N
authors.initials: N
authors.lastname: Spyridis
authors.forename: P
authors.initials: P
authors.lastname: Prasad
authors.forename: D
authors.initials: D
authors.lastname: Papaventsis
authors.forename: S
authors.initials: S
authors.lastname: Kanavaki
authors.forename: Th
authors.initials: T
authors.lastname: Zaoutis
authors.forename: M N
authors.initials: MN
authors.lastname: Tsolia
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D019353:Endemic Diseases; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D055985:Latent Tuberculosis / Q000453:epidemiology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents