RESUMEN
BACKGROUND: Most paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR. METHODS: We conducted a prospective multicentric observational study in Catalonia (Spain) from 06/2017 to 12/2019. We enrolled children aged < 15 years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent's birth country for ≥21 days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8-12 weeks post-return. LTBI was defined as a TST ≥5 mm and/or a positive QFT-Plus. RESULTS: Five hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU,95%CI = 8.8-28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3-9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU,95%CI = 3.9-20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1-13.3). CONCLUSIONS: The risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.
RESUMEN
Like other bionanomaterials, dendrimers are usually labelled with fluorescent compounds in order to be optically detected within cells. However, this process can interfere with their biological properties, so it is crucial to find other solutions for their traceability. Here, the blue intrinsic fluorescence of amine-terminated poly(amidoamine) (PAMAM) dendrimers was enhanced using oxidative treatment with ammonium persulfate (APS). The effects of dendrimer generation (G3, G4, and G5) and pH on the spectroscopic behavior of both pristine and APS-treated PAMAM dendrimers were studied in aqueous solution. Overall, the results pointed out that there are at least two types of emitting electron-rich hetero-atomic sub-luminophores (HASLs) confined within the dendrimer scaffold that have very close maximum emission wavelengths and whose emission properties strongly depend on pH. The APS treatment significantly enhanced the fluorescence intensity by leading to the protonation of the interior of the dendrimer. However, fluorescence intensity was not only dependent on the number of HASLs in the dendrimer scaffold (i.e., on dendrimer generation), but also on the rigidification suffered by the dendrimer due to the acidic environment (at low pH values, APS-treated G4 was indeed the most emissive species). Moreover, photoluminescence studies with lyophilized samples were also conducted, which confirmed the coexistence of more than one type of HASLs emitting in the dendrimer structure. The APS treatment affected these HASLs to a different extent. Time-resolved fluorescence experiments always showed higher average lifetimes of HASLs for APS-treated dendrimers than for pristine ones, in accordance with the fluorescence intensity results. On the other hand, the fraction and lifetimes of HASLs in APS-treated dendrimers were similar in solution and the lyophilized form. This behaviour was different for the pristine dendrimers that presented increased luminescence upon aggregation. Finally, the highly emissive oxidized dendrimers were shown not only to be much less cytotoxic and hemotoxic than pristine dendrimers but also to be detectable inside cells upon excitation with UV light.
