Table 1.
Age-related risks of progression to and mortality from tuberculosis disease.
| Location | Timeframe | Type of study | Sample size (denominator) from which risk was calculateda | Inclusion criteria | Definition/measurement of endpoint (TB disease or death)b | Risk per 1,000 person-years | |||
|---|---|---|---|---|---|---|---|---|---|
| Ages 0 to <5 | Ages 5 to <10 | Ages 10 to <15 | Age 15 to <20 | ||||||
| STUDIES REPORTING RISK OF PROGRESSION TO TB DISEASE, STRATIFIED BY AGE (IN YEARS) AT TIME OF DIAGNOSIS OF TB INFECTION | |||||||||
| Minneapolis, MN, U.S.A. (22, 23, 24) | 1921–1941 | Cohort study | 3,612 | TST positivity at enrollment or TST-conversion during follow-up; TST positivity defined as induration of ≥5 mm to 0.1 or 1.0 mg of old tuberculin | “Clinical TB,” not including “primary pulmonary infiltrates” on CXR in the absence of symptoms | 257 (age 0 to <1); 160 (age 1 to <2); 143 (age 2 to <3); 50 (age 3 to <4); 46 (age 4 to <5)b |
48 (age 5 to <6); 38 (age 6 to <7); 45 (age 7 to <8); 78 (age 8 to <9); 49 (age 9 to <10)b |
49 (age 10 to <11); 40 (age 11 to <12);59 (age 12 to <13); 77 (age 13 to <14); 82 (age 14 to <15)b |
50 (age 15 to <16); 108 (age 16 to <17); 52 (age 17 to <18)b |
| Massachusetts, U.S.A. (25) | 1924–1934; f/u period 1–12 (mean 11.4) years | Cohort study | 64,834 | Positive reaction (not further defined) to the von Pirquet tuberculin test | (1) All cases and deaths that were reported in Massachusetts from 1924 to 1936 and matched one of the individuals in the cohort, or (2) radiographic and clinical diagnosis of TB in a subset with follow-up exams | n/a | 0.4 | 1.7 | 3.7 |
| London, U.K. (26) | 1930–1954; f/u period 2–25 (mean 9) years | Cohort study | 1,567 | History of contact with TB case; no TST required for study entry | Children developing tuberculous lesions, further divided into intrathoracic and extrathoracic | 608 b | 432 b | 409 b | n/a |
| Kinn Administrative District, Norway (27) | 1937–1944; f/u period through 1945 | Survey | 152 | ≥3 mm induration to the von Pirquet tuberculin test | TB disease diagnosed through clinical symptoms, signs, and radiology | 778 (age 0 to <7) | 778 (age 0 to <7); 603 (age 7 to <15) |
603 (age 7 to <15) | 583 (age 15 to <20) |
| Newcastle-upon Tyne-and Northumberland, U.K. (28) | 1941–1961; f/u period 1–10 years | Cohort study and literature review | 2,376 | 8 different studies included; each study used slightly different entry criteria | Diagnoses of TB meningitis, miliary TB, pleural TB, skeletal TB, or pulmonary TB | 447 (0 to <1); 48 (0 to <2); 68 (0 to <5); 265 (0 to <7)b |
265 (0 to <7)b | n/a | n/a |
| Brentwood, Essex, U.K. (29) | 1942–1953; f/u period 5–10 years | Cohort study | 317 | Diagnosis of simple primary TB | Complications, including pulmonary TB, grave haematogenous TB, and other extrapulmonary disease | 150 (age <2); 139 (age 2 to <5)b |
144b | 177b | n/a |
| Puerto Rico, U.S.A. (18) | 1949–1969; f/u period 18–20 years | Control arm of BCG vaccine trial | 82,269 | No receipt of BCG vaccine and ≥6 mm induration to 1 or 10 units of PPD | TB disease confirmed by death certificates, case reports, and reports of admission to TB hospitals and clinics | 1.648 (age 1 to <7) | 1.648 (age 1 to <7); 0.77 (age 7 to <13) | 0.77 (age 7 to <13); 0.946 (age 13 to <19) | 0.946 (age 13 to <19) |
| STUDIES REPORTING RISK OF MORTALITY FROM TB DISEASE, STRATIFIED BY AGE (IN YEARS) AT TIME OF DEATH | |||||||||
| Philadelphia, PA, U.S.A. (30) | 1920 | Epidemiologic survey | Not specified | All white children in Philadelphia (including children without TB disease) | Death from all forms of TB, data source not specified | 0.33 (age <1), 0.14 (age 1 to <5)c | 0.07c | 0.138c | 0.763c |
| Baltimore, MD, U.S.A. (31) | 1928–1937; f/u period 1–10 years | Cohort study | 1,117 | Child contacts of TB cases (including children without TB disease) | Mortality from TB, data source not specified | Caucasians: 11.86 (age <1), 4.3 (age 1 to <5); African-Americans: 59.68 (age <1), 18.55 (age 1 to <5) | Caucasians: 0.88; African-Americans: 3.8 | Caucasians: 0; African-Americans: 2.77 | Caucasians: 7.54; African-Americans: 21.62 |
| Massachusetts, U.S.A. (32) | 1930 | Epidemiologic survey | Not specified | All children in Massachusetts (including children without TB disease) | Deaths from all forms of TB, from U.S. Mortality Statistics | Males: 0.41; Females: 0.27 | Males: 0.11; Females: 0.13 | Males: 0.21; Females: 0.37 | |
| Kingsport, TN, U.S.A. (33) | 1930–1931 | Epidemiologic survey | Not specified | All children (including healthy children) from 132 African-American households with TB | TB-related deaths reported from interviews with family members | 2.9 (age <1), 0.8 (age 1 to <5)b | 1.6b | 4.2b | |
| Stockholm, Sweden (34) | 1930–1938 | Cohort study | 453 | Diagnosis of primary TB | Death, data source not specified | 359 (age <1); 156 (age 1 to <3); 44 (age 3 to <7)c |
44 (age 3 to <7); 8 (age 7 to <16)c |
8 (age 7 to <16) c | n/a |
| New York, NY, U.S.A. (35) | 1930–1947 | Cohort study | 964 | Radiologic evidence of primary TB | Deaths from TB meningitis and other complications of primary TB, including disseminated forms and local progression of primary forms | 475 (age <0.5); 360 (age 0.5 to <1); 230 (age 1 to <2); 280 (age 2 to <3); 150 (age 3 to <5)b, c |
150b, c | 210b, c | n/a |
| Brentwood, Essex, U.K. (29) | 1942–1953; f/u period 5-10 years | Cohort study | 712 | Diagnosis of TB disease of any severity, including simple primary TB | Deaths from TB, data source not specified | 60 (age <2); 1 (age 2 to <5)b |
1b | 40b | n/a |
a
Whereas, Marais and colleagues reported the entire study population in their 2004 review article, we are reporting the population from which the risk was calculated.
b
Risks given as per 1,000 persons rather than per 1,000 person-years.
c
These risks were extrapolated from a line graph in the original report, and age was defined at time of diagnosis of TB disease.
BCG, Bacillus Calmette-Guérin; CXR, chest radiography; f/u, follow-up; PPD, purified protein derivative; TB, tuberculosis; TST, tuberculin skin test.