Tuberculosis contact tracing among children and adolescent referred to children's hospital in Rio de Janeiro, Brazil

OBJECTIVE: To describe the investigation of latent tuberculosis infection and indication for isoniazid preventive therapy in children and adolescents evaluated at the children's hospital. METHODS: This retrospective study examines all latent tuberculosis infection subjects with indication for isoniazid preventive therapy attended during 2002–2009 at the pulmonology outpatient clinic from children's hospital in Rio de Janeiro, Brazil. The subjects were classified into three groups by origin: (G1) primary and secondary health units; (G2) children's hospital-pulmonology outpatient clinic; and (G3) children's hospital-specialty outpatient clinics. The association between the variables examined and G1 was analyzed using univariate analysis. RESULTS: Of the 286 latent tuberculosis infection cases included 169 (59.1%) were from G1, 56 (19.6%) from G2, and 61 (21.3%) from G3. Latent tuberculosis infection diagnosis without isoniazid preventive therapy prescription was present in 142 (49.6%) cases before arrival at the pulmonology outpatient clinic: 135 (95.1%) from G1, three (2.1%) from G2, and four (2.8%) from G3. Variables associated with G1 were presence of isoniazid preventive therapy criteria before attending the pulmonology outpatient clinic (OR: 62.3; 26.6–146.2), negative HIV infection status (OR: 9.44; 1.16–76.3); contact with pulmonary tuberculosis (OR: 5.57; 1.99–15.5), and residing in Rio de Janeiro city (OR: 1.89; 1.04–3.44). CONCLUSION: Strategies that increase latent tuberculosis infection identification and isoniazid preventive therapy prescription in primary and secondary health units are urgently needed.