Tuberculosis in the Home: Contact History and Childhood Tuberculosis in Central Harlem

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

Tuberculosis in the Home: Contact History and Childhood Tuberculosis in Central Harlem

Clinical Pediatrics (12/98) Vol. 37, No. 12, P. 753
Moss, William

Dr. William Moss of the Johns Hopkins School of Hygiene and Public Health reports on contact history of childhood cases of tuberculosis in Central Harlem, New York City. The area had the highest tuberculosis rate in the city in 1993, with an age -adjusted rate of 182 cases per 100,000 people. The number of reported cases of TB among children aged younger than 15 years increased 97 percent from 1989 to 1990 in the city. Moss reviewed medical records of reported cases of children with TB between January 1982 through December 1993 from the Harlem Hospital Center. He found 40 children under the age of 18 who were treated for tuberculosis with a peak incidence of 13 cases in 1989. Moss found that the majority of the children were born in the United States, had no travel history, and reported their mothers as their primary caretaker. Household contact with a person with TB infection or disease or a history of infection was found for 35 of the children; but only six cases were identified through contact tracing of adult cases. Thirteen of the cases could potentially have been prevented if the child had been given preventive therapy at the time of diagnosis of the source case. Moss concludes that "contact tracing and institution of preventive therapy were inadequate in preventing childhood tuberculosis in this group of hospitalized children." He suggests the identification and treatment of adult source cases to help prevent the spread of the disease in children.

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