title: [Adolescent tuberculosis; a challenge and opportunity to prevent community transmission].
abstract: BACKGROUND
  Adolescents may present with adult-type pulmonary tuberculosis (TB), including cavity disease in upper lobes and smear-positive sputum, which involves a significant transmission risk for social and family contacts.
  
  
  METHODS
  A retrospective (2007-2012) observational study of a case series of TB was conducted in children and adolescents (<18 years) in a paediatric referral centre in Barcelona. Patients aged≤12 and>12 years at diagnosis are compared.
  
  
  RESULTS
  The series consisted of 124 patients (56.5% males, median age: 4.0 years). In half of the cases, the patient was of immigrant origina and TB was diagnosed after clinical-radiological suspicion, intra-thoracic disease being the most common (91.9%). Cultures yielded positive results in one third of cases (37.9%) and isolates were sensitive to oral first-line anti-TB agents in 100%. Median (interquartile range) duration of treatment was 6 (6-9) months, directly observed therapy was needed in 10 patients, and there was a satisfactory outcome after treatment in 98.4%. Among adolescents, TB was more prevalent in females (63.2%) and immigrant patients (68.4%), comorbidity at diagnosis and lung cavity forms were more common, and the source case was identified only in 21.1% of the patients.
  
  
  CONCLUSIONS
  Adult-type pulmonary TB is common among adolescents, may be associated with underlying medical conditions, and is often diagnosed late, posing a significant transmission risk to the community.
authors.affiliation: Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España.
authors.forename: Adriana
authors.initials: A
authors.lastname: Margarit
authors.affiliation: Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Simó
authors.affiliation: Unitat de Referència de Tuberculosi en el Nen, Direcció d'Infermeria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España.
authors.forename: Librada
authors.initials: L
authors.lastname: Rozas
authors.affiliation: Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España.
authors.forename: Àngela
authors.initials: À
authors.lastname: Deyà-Martínez
authors.affiliation: Unitat de Vigilància Epidemiològica, Regió Barcelona Sud, Agència de Salut Pública de Catalunya, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Irene
authors.initials: I
authors.lastname: Barrabeig
authors.affiliation: Servei de Microbiologia, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: Amadéu
authors.initials: A
authors.lastname: Gené
authors.affiliation: Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España.
authors.forename: Clàudia
authors.initials: C
authors.lastname: Fortuny
authors.affiliation: Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deú, Universitat de Barcelona, Barcelona, España. Electronic address: ton@hsjdbcn.org.
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D011634:Public Health; D012189:Retrospective Studies; D013030:Spain; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission*
keywords: Adolescent; Adolescente; Adult-type disease; Contagio; Enfermedad tipo adulto; Paediatrics; Pediatría; Transmission; Tuberculosis