Global Health Investigators Receive Award for Tuberculosis Risk Factor Study

05/6/2010

Investigators from the Children’s Hospital Global Health team received the Burtis Burr Breese Award for a study that identified risk factors for tuberculosis. This annual award is given to the authors of the paper published in The Pediatric Infectious Disease Journal that best illustrates the principles and practices of Burtis Burr Breese, MD, a pioneer in studies of infectious diseases. Dr. Breese, who died in 1998, was dedicated to controlled research to answer questions that could contribute to the understanding and cure of pediatric diseases.

The study intended to identify risk factors for tuberculosis among children living in migrant populations in the Dominican Republic. Tuberculosis is a global pandemic despite the availability of treatment. “Children living in areas affected by tuberculosis experience considerable morbidity and mortality related to the disease, and those who are latently infected can infect others throughout their lives,” says Samir Shah, MD, MSCE, the senior author of the study and research director of Global Health.

The risk of tuberculosis is high among children in refugee and migrant communities, groups that encounter barriers to healthcare resources for accurate diagnosis and treatment. A better understanding of risk factors within high-risk populations may lead to the development of targeted interventions to prevent recurring infections within a community.

Led by Keri Cohn, M.D., a former Children’s Hospital resident, the study team evaluated tuberculosis tests for 400 children living in two economic migrant communities of Haitian origin in the Dominican Republic and diagnosed 83 children (20.8 percent) with probable or possible tuberculosis. In addition to this high prevalence of disease, the study team identified that unpasteurized milk consumption was associated with the development of tuberculosis.

Most cases of tuberculosis in humans are caused by Mycobacterium tuberculosis; however, Mycobacterium bovis, the bacterium that causes tuberculosis in cattle and other animals, also infects humans. Human disease caused by M. bovis is clinically and radiographically indistinguishable from that caused by M. tuberculosis. It is possible that the association between unpasteurized milk consumption and tuberculosis infections can be partly attributed to M. bovis.

Further studies are needed to determine whether the high prevalence of tuberculosis seen in these communities can be attributed to M. bovis, information that could lead to preventative measures with the potential to reduce the impact of tuberculosis in children in these and other high-risk communities.

According to Caroline Breese Hall, MD, Dr. Burtis Burr Breese’s daughter, the authors of this paper “… have demonstrated well the spirit of my father’s work. He believed that unique contributions could and should be made from research which stems from enjoyment, curiosity, and clinical skills afforded by the daily care of patients.”

The Pediatric Infectious Diseases Society will present the authors with the award on May 3. Study co-authors include Rodney Finalle, MD, and Geraldine O’Hare, MSN, CRNP, from Children’s Hospital, and Josefina Fernandez, MD, and Jesus M. Feris, MD, from the Robert Reid Cabral Hospital in Santo Domingo, Dominican Republic.