Navigation Links
Doctors call for change in how non-active TB in immigrant children treated
Date:3/2/2009

INDIANAPOLIS New guidelines proposed in the March 2009 issue of the journal Pediatrics by researchers from the Indiana University School of Medicine and Riley Hospital for Children may have a major impact on how U.S. pediatricians and family physicians treat non-active tuberculosis (TB) in children who are immigrants, internationally adopted or refugees. The researchers say the strategy should improve the health of this growing number of children and save healthcare dollars.

An estimated one-third of the world's men, women and children have TB. Most cases are non-active ones (also called latent) in which individuals have the TB bacteria in their body but their immune system keeps it in check. While they are not actively sick they are at risk of developing active TB and spreading the disease.

Young children under age 5 with non-active TB have a higher rate of developing the active disease than adults. Estimates indicate that between 10 percent and 20 percent of these children will go on to develop active TB. To prevent this from happening, children with latent TB are treated with medication.

"As a pediatrician in the International Adoption Clinic at Riley Hospital, I see patients with non-active TB on a daily basis. These children come from around the world, many from Russia and other countries of the former Soviet Union, China and Vietnam. The children have often lived in crowded conditions in orphanages -- the type of setting where TB is especially common. These are also among the countries where many TB cases have become resistant to the drug isoniazid. Yet standard U.S. treatment guidelines call for us to use this drug for all latent TB infections in children," said Maria Finnell, M.D., first author of the study.

Using sophisticated computer modeling, Dr. Finnell, who is a pediatrics fellow, and her Riley Hospital co-authors John C. Christenson, M.D., IU School of Medicine professor of clinical pediatrics and an infectious disease specialist, and Stephen M. Downs, M.D., IU School of Medicine associate professor of pediatrics and a Regenstrief Institute affiliated scientist, determined that treatment guidelines need to be changed so that children with non-active TB who come to the U.S. from countries with high rates of isoniazid resistance are treated with another drug called rifampin. Rifampin currently is used only in children exposed to known cases of isoniazid resistant TB.

"As we can't find the actual bacteria in patients with non-active TB, we have no way of knowing which children have the isoniazid-resistant strain. Our analysis shows that for those with latent TB who come from countries with isoniazid-resistant rates above 11 percent, treatment with rifampin would be cost-effective. Even though rifampin is a more expensive drug than isoniazid, we would lower total costs because using rifampin would prevent more cases of active TB. As an added benefit, the course of rifampin is six months rather than the nine months of therapy required for isoniazid, which may improve adherence. In parts of the world, more than 40 percent of the active TB cases are now isoniazid resistant. We need to consider where a child came from, what the rate of resistance is in that country, and tailor the medication to that," said Dr. Finnell.

According to Dr. Finnell, there has been no previous analysis of this type for pediatric non-active TB patients, although similar analyses have been done for adults. And she notes that the benefits of treating non-active TB far exceed the minimal risk of side effect in children.


'/>"/>

Contact: Cindy Fox Aisen
caisen@iupui.edu
317-274-7722
Indiana University
Source:Eurekalert  

Related medicine news :

1. New tool guides doctors to save cancer patients fertility
2. New ASCO/AUA guideline recommends men and their doctors discuss using 5-ARIs to reduce prostate cancer risk
3. Treating drug-addicted doctors is good medicine
4. Doctors Guide to Cancer Drugs May Need Revising
5. Many Hospital Patients Cant ID Their Doctors
6. Wanted: Pioneer IVF Babies Bay Area Fertility Doctors Launch National Search for First IVF Babies Born 25 Years Ago
7. Doctors Fear Patients Not Filling Prescriptions
8. Unbelievable Lack Of Marketing Knowledge Forces Doctors To Quit Practice.
9. Doctors of Optometry Cheer Obamas Call to Action on Childrens Vision
10. Consumer Advocates Call on Legislature to Support Governors Ban on Pharmaceutical Gifts to Doctors
11. Study shows that primary care doctors miss opportunities to recommend colon cancer screening
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Doctors call for change in how non-active TB in immigrant children treated
(Date:1/17/2017)... York (PRWEB) , ... January 17, 2017 , ... ... – SightMD – will lecture to primary eye care practitioners on the latest ... at the upcoming 13th Semi-Annual Continuing Education Symposium, according to eye surgeon, Jeffrey ...
(Date:1/17/2017)... , ... January 17, 2017 , ... ... financial planning assistance to families and business professionals throughout central Colorado, is joining ... homeless families. , The Aurora Warms The Night organization is committed to breaking ...
(Date:1/17/2017)... (PRWEB) , ... January 17, 2017 , ... ... and breast cancer survivor Sandra Lee as keynote speaker for the 34th Annual ... Florida. , In making the announcement, PER® president, Phil Talamo, said, “We are ...
(Date:1/17/2017)... ... January 17, 2017 , ... Today, FloSports , a ... announced a new agreement as part of a long-term extension of their media partnership. ... the airing of some of the sport’s premier events exclusively on FloWrestling.com as well ...
(Date:1/16/2017)... ... ... California Southern University has named Dr. Steven Beazley University President. ... a core faculty member, teaching master’s and doctoral courses in the university’s School of ... where he earned his Doctor of Psychology degree in 1998. Dr. Beazley also has ...
Breaking Medicine News(10 mins):
(Date:1/17/2017)... -- Research and Markets has announced the addition of ... to their offering. ... The global fluoropolymer market in the healthcare industry to grow ... Global Fluoropolymer Market in the Healthcare Industry 2016-2020, has been ... experts. The report covers the market landscape and its growth prospects ...
(Date:1/17/2017)... , Jan. 17, 2017 Following an ... today praised the Food and Drug Administration,s (FDA,s) ... Human Drug Products by Pharmacies and Outsourcing Facilities." ... proposed limitation on pre-packaging -- which would have ... costs to long term care (LTC) pharmacies.  ...
(Date:1/17/2017)... ReportsnReports.com adds "Anaphylaxis - Pipeline Review, H2 2016" ... Anaphylaxis,s therapeutic pipeline with comprehensive information on the therapeutic development ... assessment by drug target, mechanism of action (MoA), route of ... featured news and press releases. ... Complete report on H2 2016 pipeline ...
Breaking Medicine Technology: