Epidemiological characteristics and trends of paediatric tuberculosis cases in Spain, 2012-2023

Background Children are a particularly vulnerable population for tuberculosis (TB). The present study aims to describe epidemiological characteristics and temporal trends of paediatric TB in Spain. Methodology A retrospective study of paediatric TB in Spain was conducted using data from the National Epidemiological Surveillance Network and the l Basic Minimum Data Set of Hospitalizations from 2012 to 2023. Trends of annual notification rates (NR), hospitalization rates (HR) and annual percentage of change (APC) were calculated. Results Between 2012 and 2023 there were 3,472 reported cases and 2,768 hospitalizations. The mean NR and HR of the period were 4.2 and 3.3 per 100,000 inhabitants, respectively. The NR and the HR decreased from 5.0 to 3.5 and from 5.0 to 2.8, with significant APCs of -5.05 and -7.25, respectively. The most affected age group was 1-4 (39.8% of notifications and 43.4% of hospitalizations). Severe presentations (miliary and meningitis) were more common amongst cases less than 1-year-old. Conclusions A decreasing trend in paediatric TB in Spain has been observed since 2012, with a slight rebound since 2021. Younger children aged 1-4 had the highest incidence while children under 1 year had the highest percentage of severe TB. This highlights the importance of prioritizing and strengthening control strategies in this age group.