Current Diagnosis of Infant Tuberculosis Infection


by

Paulo R. Z. Antas

DOI: 10.2174/97816080530251120101
eISBN: 978-1-60805-302-5, 2012
ISBN: 978-1-60805-658-3

  
  


Indexed in: Scopus

One of the most extraordinary characteristics of Mycobacterium tuberculosis infection is its capacity to remain within the host's tiss...[view complete introduction]
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Table of Contents

Foreword , Pp. i

Paul R. Klatser and Tom H. M. Ottenhoff
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Preface , Pp. ii

Paulo R.Z. Antas, Dilvani O. Santos, Roberta O. Pinheiro and Theolis Barbosa
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List of Contributors , Pp. iii

Paulo Renato Zuquim Antas, Dilvani Oliveira Santos, Roberta Olmo Pinheiro and Theolis Barbosa
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Acknowledgements , Pp. iv

Paulo Renato Zuquim Antas, Dilvani Oliveira Santos, Roberta Olmo Pinheiro and Theolis Barbosa
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Introduction , Pp. 3-10 (8)

Luiz R.R. Castello-Branco and Paulo R.Z. Antas
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Natural History of Tuberculosis in the Human Host: Infection, Latency and Active Disease. Are these Treatable? , Pp. 11-18 (8)

Dilvani O. Santos, Selma M.A. Sias and Paulo R.Z. Antas
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Epidemiology of Tuberculosis Infection in Children , Pp. 19-26 (8)

Roberta O. Pinheiro and Paulo R.Z. Antas
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Immune Responses for Tuberculosis in the Infected Infant , Pp. 27-34 (8)

Dilvani O. Santos and Paulo R.Z. Antas
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Classical Diagnosis of Tuberculosis , Pp. 35-48 (14)

Roberta O. Pinheiro and Paulo R.Z. Antas
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Radiology in Pulmonary Tuberculosis , Pp. 49-64 (16)

Almerio S. Machado and Paulo R.Z. Antas
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New Laboratory Techniques for the Diagnosis of Tuberculosis , Pp. 65-81 (17)

Theolis Barbosa and Paulo R.Z. Antas
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Perspectives of Tuberculosis Management in Pediatric Disease , Pp. 82-90 (9)

Selma M.A. Sias, Clemax C. Sant´Anna and Paulo R.Z. Antas
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Appendix , Pp. 91-101 (11)

Paulo Renato Zuquim Antas, Dilvani Oliveira Santos, Roberta Olmo Pinheiro and Theolis Barbosa
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Glossary of Terms , Pp. 102-105 (4)

Paulo Renato Zuquim Antas, Dilvani Oliveira Santos, Roberta Olmo Pinheiro and Theolis Barbosa
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Index , Pp. 106-108 (3)

Paulo Renato Zuquim Antas, Dilvani Oliveira Santos, Roberta Olmo Pinheiro and Theolis Barbosa
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Foreword

In 2006 alone, worldwide 9.2 million people developed tuberculosis (TB) for the first time, of which 15-20% are children. The largest numbers of cases occurred in India, China and Indonesia, while the African continent, particularly sub-Saharan Africa, continued to feature the highest incidence rates (363/100,000 people). Approximately 1.7 million individuals died from TB; 0.2 million of which occurred in HIV-co-infected cases. TB continued to be the leading cause of death in HIV-infected individuals in Africa. TB predominantly affects young adults, and thereby hampers sustainable development in developing countries, perpetuating the poverty cycle. Aggravating the current situation is the rising frequency of multi-drug resistant TB (MDR-TB) strains, which are resistant to the front-line drugs isoniazid and rifampicin. Sadly, MDR-TB is an iatrogenic problem, preventable by adequate treatment and compliance. More recently, extensively drug resistant TB (XDR-TB) has emerged, with additional resistance to fluoroquinolone derivatives and at least one of the second-line injectable drugs (amikacin, kanamycin and/or capreomycin). XDR-TB has an extremely high case fatality rate in HIV-affected patients. Fears are that MDR- and XDR-TB may throw us back into the pre-antibiotic era, posing the threat of a virtually untreatable disease.

Thus, TB continues to pose formidable challenges to global health at the public health-, scientific- and political level. Our tools to combat TB are dangerously out of date, ineffective, or non-existent, such as easy non-invasive diagnostics for infant TB. Besides new tools (TB-drugs, vaccines, diagnostics), we also need new strategies to identify key M. tuberculosis / human host interactions, since it is here that we can most likely find Mtb's vulnerable spot. Equally important is that we build high quality clinical trial capacity and biobanks for TB biomarker identification. But most important is a global commitment at all levels to roll back TB before it outwits us again.

The current book Current Diagnosis of Infant Tuberculosis Infection is a highly welcome addition to already existing scholarship since it uniquely underscores the relevance of all aspects of TB in the most vulnerable population of all: infants. The book's scope ranges from basic immunology and microbiology all the way to clinical manifestations, diagnosis, treatment and management of TB as well as TB epidemiology. It cannot be overemphasized how important it is to bring TB back into the center of public attention, a place in which it should be in view of its horrifying consequences for affected individuals and populations.

Paul R. Klatser
Head of Department
KIT Biomedical Research
Royal Tropical Institute, Amsterdam
The Netherlands

Tom H. M. Ottenhoff, MD, PhD
Professor of Immunology
Head Group Immunology and Immunogenetics of Bacterial Infectious Diseases
Dept. of Infectious Diseases
Leiden University Medical Center, Leiden
The Nederlands


Preface

One of the most extraordinary characteristics of M. tuberculosis infection is its capacity to remain within the host's tissues for a long period of time. There is an enormous reservoir of persons latently infected with tuberculosis, estimated at about a third of the world's population. From this reservoir arise about 10 million new cases of active tuberculosis and more than two million deaths annually.

The natural history and clinical expression of infection due to M. tuberculosis differ substantially in children depending upon the age at infection and the host immune status. Children infected prior to age 4 are very unlikely to develop reactivation disease in adulthood, however, they have a very high rate of developing immediate clinical or radiographic manifestations, or both. In contrast, children infected in preadolescence or adolescence are more prone to develop more severe adult-type pulmonary tuberculosis soon after infection or in adulthood. Also, children with tuberculosis respond well to and tolerate the same basic treatment regimens as used for adults. Some prevention of childhood tuberculosis can be achieved by the use of the bacille Calmette-Guérin (BCG) vaccines, but the use of chemotherapy to treat recent tuberculosis infection, discovered via contact tracing, is of paramount importance even when BCG vaccines are used.

The purpose of this ebook, "Current Diagnosis of Infant Tuberculosis Infection", is to introduce the reader the main problems involved in the diagnosis of this disease, giving an overview of commercially available options while, unlike most reviews on the subject, also explore tools currently under development. Our goal is to provide a comprehensive overview and update for the reader, particularly for pediatricians. Furthermore we hope the text is of use to universities and research centers, as well as all interested hospital personnel. We believe that providing understandable and practice-oriented information on this subject, while keeping in mind frontier research developments, will help clinicians improve their diagnostic skills regarding tuberculosis infection in child. Each co-author provides the view from his/her field of expertise, benefiting from the experience of working with mycobacteriosis in the endemic country of Brazil. Brazil is one of the 22 countries listed with the highest burden of tuberculosis worldwide. We emphasize a knowledge-based product of the highest quality for the academic, professional, and student communities worldwide.

We would like to express our sincere appreciation to all of the authors who contributed chapters to this e-book. We also would like to thank Bentham Science Publishers for their very kind support and efforts.

EDITOR Paulo R.Z. Antas
Laboratório de Imunologia Clínica
Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro
Brazil.

CO-EDITORs Dilvani O. Santos
Laboratório de Biopatógenos e
Ativação Celular
Instituto de Biologia
Universidade Federal
Fluminense
Niterói, Brazil

Roberta O. Pinheiro
Laboratório de
Hanseníase
Instituto Oswaldo Cruz
Fiocruz
Rio de Janeiro, Brazil

Theolis Barbosa
Laboratório Integrado de
Microbiologia e Imunoregulação
Centro de Pesquisas Gonçalo
Moniz, Fiocruz, Salvador
Brazil

List of Contributors

Editor(s):
Paulo R. Z. Antas
Laboratório de Imunologia Clínica (LIC)
Instituto Oswaldo Cruz - Fiocruz
Brazil




Co-Editor(s):
Dilvani Oliveira Santos
Instituto de Biologia
Universidade Federal Fluminense (UFF)
Brazil


Roberta Olmo Pinheiro
Laboratório de Hanseníase
Instituto Oswaldo Cruz - Fiocruz
Brazil


Theolis Barbosa
Laboratório Integrado de Microbiologia e Imunoregulação (LIMI)
Centro de Pesquisas Gonçalo Moniz (CPqGM) - Fiocruz
Brazil




Contributor(s):
Almério de Souza Machado Jr.
Escola Bahiana de Medicina e Saúde Pública
Salvador
Brazil


Dilvani Oliveira Santos
Universidade Federal Fluminense
Niterói
Brazil


Luíz Roberto Ribeiro Castello-Branco
Instituto Oswaldo Cruz, Fiocruz
Rio de Janeiro
Brazil


Paulo Renato Zuquim Antas
Parasitology, Fundação Oswaldo Aranha, UNIFOA
Volta Redonda
Brazil


Roberta Olmo Pinheiro
Instituto Oswaldo Cruz, Fiocruz
Rio de Janeiro
Brazil


Selma Sias
Hospital Universitário Antônio Pedro
Universidade Federal Fluminense
Niterói
Brazil


Theolis Barbosa
Public Health
Centro de Pesquisas Gonçalo Moniz, Fiocruz
Salvador
Brazil




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