title: Risk Factors for Central Nervous System Tuberculosis.
abstract: OBJECTIVE
  To describe the epidemiology and factors associated with pediatric central nervous system (CNS) tuberculosis (TB) in California from 1993 to 2011.
  
  
  METHODS
  We analyzed California TB registry data for persons aged ≤18 years, comparing CNS TB cases versus non-CNS TB cases reported from 1993 to 2011. Factors associated with CNS TB and TB deaths were identified by using multivariate logistic regression.
  
  
  RESULTS
  A total of 200 CNS TB cases were reported. Compared with non-CNS TB case patients, CNS TB case patients were more likely to be aged <5 years (72.0% vs 43.6%; odds ratio [OR]: 3.8 [95% confidence interval (CI): 2.4-5.9]), US-born (82.0% vs 58.2%; OR: 3.3 [CI: 2.3-4.7]), and Hispanic (75.0% vs 63.2%; OR: 1.7 [CI: 1.3-2.4]). Among US-born CNS TB case patients (during 2010-2011), 76.5% had a foreign-born parent. Tuberculin skin test results were negative in 38.2% of 170 CNS TB cases tested. In multivariate analysis, age <5 years (adjusted odds ratio [aOR]: 3.3 [CI: 2.0-5.4]), US birth (aOR: 1.8 [CI 1.2-2.7]), and Hispanic ethnicity (aOR: 1.5 [CI: 1.1-2.1]) were associated with an increased risk of developing CNS TB. For deaths, CNS TB (aOR: 3.8 [CI: 1.4-9.9]) and culture positivity (aOR: 6.2 [CI: 2.2-17.3]) were associated with increased risk of death, whereas tuberculin skin test positivity (aOR: 0.1 [CI: 0.04-0.2]) was associated with decreased risk.
  
  
  CONCLUSIONS
  Subsets of children are at increased risk for CNS TB in California and may benefit from additional prevention efforts.
authors.affiliation: UCSF Benioff Children's Hospital Oakland, Oakland, California; and Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Duque-Silva
authors.affiliation: Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California.
authors.forename: Katherine
authors.initials: K
authors.lastname: Robsky
authors.affiliation: Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Flood
authors.affiliation: Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California pennan.barry@cdph.ca.gov.
authors.forename: Pennan M
authors.initials: PM
authors.lastname: Barry
mesh_terms: D000367:Age Factors; D002140:California / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015999:Multivariate Analysis; D012042:Registries; D012307:Risk Factors; D020306:Tuberculosis, Central Nervous System / Q000453:epidemiology*