Advances in Microbiology, Infectious Diseases and Public Health

Emanuele Nicastro, Riccardo Scotto, Diana Cerullo, Maria Cristina Fedele, Eugenia Bruzzese, Vania Giacomet, Maria Immacolata Spagnuolo, Alfredo Guarino, Andrea Lo Vecchio, Nicastro, Emanuele, Scotto, Riccardo, Cerullo, Diana, Fedele, Maria Cristina, Bruzzese, Eugenia, Giacomet, Vania, Spagnuolo, Maria Immacolata, Guarino, Alfredo, Lo Vecchio, Andrea

Tuberculosis is a major problem in children depending on their families for management and a re-emerging disease in low incidence countries, where foreign-born cases account for a large proportion of cases. We investigated socioeconomic features of families and their impact on management and outcome of children with tuberculosis disease seen at a tertiary care centre for paediatric infectious diseases in Italy. Forty-nine Italian and 30 foreign-origin children were included. Children from foreign families had more complicated diseases (20 % vs 0 %; P = 0.002), harbored more drug resistant strains (20 % vs 2 %; P = 0.011), showed longer hospital stay (12 ± 13.1 vs 5.1 ± 6.5 days; P = 0.012) and higher proportion of missed medical visits (15.7 ± 16 vs 8.6 ± 9.6; P ≤ 0.042) than those from Italian families. Harboring drug resistant strains was an independent risk factor for complicated disease course (OR: 72.98; 95 %CI: 1.54-3468.58; P = 0.029), and this risk is higher in children from Eastern Europe (OR: 10.16; 95 %CI: 1.7-61.9; P = 0.012). Children from immigrant families showed an increased risk of complicated course of tuberculosis due to a higher rate of resistant strains and raise problems in clinical management. Specific protocols are needed to support these populations ensuring easy access to health services and monitoring.