Pediatric Latent Tuberculosis in Santa Catarina: Clinical-Epidemiological Profile and Challenges at a Referral Center

Abstract

Introduction: Tuberculosis is a major global public health issue, especially among children, who are more susceptible to severe forms of the disease. Oriented by international recommendations, Brazil has adopted screening and treatment of latent tuberculosis infection (LTBI) as a key strategy for disease control. Understanding the clinical-epidemiological characteristics of children with LTBI is essential for the success of this approach. Objective: To describe the clinical-epidemiological characteristics of children with LTBI at a referral hospital in southern Brazil. Methods: Retrospective, observational, and descriptive study analyzed medical records of patients aged 0-15 years diagnosed with LTBI between June 2020 and March 2024. Cases with positive tuberculin skin test or IGRA, without evidence of active tuberculosis, were included. Results: Among 64 analyzed cases, 54.69% were female and 42.19% were preschoolers. High loss to follow-up was observed (64% did not return after a non-reactive first test). The predominant profile was white children (85.94%) vaccinated with BCG (96.88%). Transmission occurred mainly through intrafamily household contact (79.69%), with the pulmonary form being the most frequent (89.06%) among index cases. The corrected LTBI prevalence was 73.21%, with drug resistance identified in 7.82% of contacts. Of the total, 41 patients adhered to the proposed conduct (64.06%), and loss of follow-up was registered in 22 cases (34,92%). Conclusion: LTBI showed higher prevalence in preschoolers and school-aged children, with predominantly household transmission. The findings highlight the need to strengthen epidemiological surveillance and active contact tracing to interrupt the chain of tuberculosis transmission.