Clinico-epidemiological profile and diagnostic procedures of pediatric tuberculosis in a tertiary care hospital of western Nepal-a case-series analysis

Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Shah, Ravi Kumar; Baniya, Ramkaji; Swain, Pradipta K

doi:10.1186/1471-2431-10-57

Cited by 21 publications

(21 citation statements)

References 17 publications

(20 reference statements)

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“…results were similar to those of other studies, such as in Uganda 18 and Nepal, 19 in which .50% of children hospitalized with TB had EPTB. This high proportion of EPTB in children may be due to their immature immune systems: TB often progresses rapidly from infection with MTB to disease.…”

Section: Figuresupporting

confidence: 82%

“…20 The most common location for EPTB in our study was TBM (38.8%) followed by DTB (31.3%). In contrast, other studies 10,19 have reported that the lymph nodes are the leading presentation for patients with EPTB. The difference may lie in our study being a hospital-based series of pediatric TB patients who are likely to be more ill than those diagnosed as outpatients and may therefore have higher rates of severe TB (TBM and DTB).…”

Section: Figurementioning

confidence: 43%

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Pediatric Tuberculosis at Beijing Children’s Hospital: 2002–2010

Yin

Jiao

et al. 2012

Pediatrics

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OBJECTIVE: Our aim was to describe the patient characteristics, clinical–epidemiological profile, and treatment outcome of childhood tuberculosis (TB). METHODS: A retrospective, descriptive study was undertaken of 1212 children aged 0 to 18 years admitted to Beijing Children’s Hospital for the treatment of TB from January 2002 to December 2010. Statistical significance of category variables was evaluated by using Fisher’s exact test. RESULTS: Fifty-four percent of patients had extrapulmonary tuberculosis (EPTB), 38.8% had tuberculous meningitis, and 31.3% had disseminated TB. The last 2 types were defined as severe TB. Most patients with TB (81.6%) were cured or completed treatment. There were more patients aged <5 years and from rural areas with EPTB than with pulmonary tuberculosis. More severe cases of TB were found in patients aged <1 year than other less severe types of TB. Patients with no bacille Calmette-Guérin vaccination and a contact history at home had a significantly risk of contracting severe TB. Children aged <1 year and those with severe TB were more likely to have poor treatment outcomes (failed to improve or died). Among those with EPTB, only 61.3% and 61.1% had positive results on the purified protein derivative tuberculin skin test and chest radiograph, respectively. CONCLUSIONS: In this referral hospital setting, more pediatric EPTB and severe TB patients were found among children aged <1 year. Age <1 year and having severe TB were risk factors for treatment failure. Thus, prevention and health care in pediatric TB should focus on both EPTB and severe TB.

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Section: Figuresupporting

confidence: 82%

Section: Figurementioning

confidence: 43%

Pediatric Tuberculosis at Beijing Children’s Hospital: 2002–2010

Yin

Jiao

et al. 2012

Pediatrics

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“…These findings are on par with findings of Sreeramareddy et al who also reported same risk factors association in his study. 16 Fever was the most common presenting complaint in both PTB and EPTB in Present study followed by cough, loss of appetite and weight which is also reported in many studies globally. However, few studies reported cough, loss of appetite and weight as most common features in pulmonary tuberculosis.…”

supporting

confidence: 64%

Risk factors, clinico-epidemiological profile of tuberculosis among children attending a tertiary care hospital: a two year study

Tenali¹,

Badri²,

Kandati³

et al. 2018

Int J Contemp Pediatr

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Background: TB remains as the one among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease with 0.4 million with HIV. At least 1 million children become ill with TB each year. Children represent about 10-11% of all TB cases. Having knowledge of the risk factors for tuberculosis infection in children is important to evaluate the level of ongoing transmission of infection and to help adapt activities within national TB control programs. The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Methods: The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Results: 98 cases of TB were confirmed out of total 628 with a prevalence of 17.07% in the study with 78 PTB cases and 20 EPTB. Females were more with male to female ratio of 0.7:1.5-9 years was the most common age group in the study. Statistically significant association was found between old history of ATT, HIV positivity, contact with an open case of TB and malnutrition (p value<0.05). TB meningitis was the most common EPTB (10/20 cases) followed by tuberculous lymphadenitis (5/20). 69.39% (68/98 cases) were smear positive, radiologically 59.18% of cases were positive and Tuberculin skin test was positive in 46.94%.Conclusions: Childhood tuberculosis is a neglected entity in developing countries due to underreporting and difficulties in diagnosis due to variable clinical picture in children. Hence epidemiological surveillance studies in children are required to determine the actual prevalence of pulmonary and extra pulmonary cases of tuberculosis. Increased efforts are required to isolate TB bacilli from body fluids to identify early the childhood cases and manage them to prevent disease burden in the community.

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“…[12][13][14] We observed that lymph node was the most common extra pulmonary site which has been affected by TB; Arora VK et al, Gocmen A et al, Ramesh et al and Sreeramareddy et al also shown similar findings as current study. 5,7,15,16 In the present study 83.87% patients completed the DOTS treatment, 10.75% were cured, so treatment success was seen in 94.60% of total cases. Various studies done by Sharma S et al, Satyanarayan et al, Arora VK et al and Indumati CK et al also DOTS treatment success rate more than 94%.…”

Section: Discussionmentioning

confidence: 81%

“…6 Similarly Sreeramareddy et al and S Shrestha et al observed similar symptoms in patients of their respective study. 7,8 We noticed history of contact with TB infection in 39% of patients while 61% had no history of contact with TB; a study conducted at ICH Chennai by Vijayasekaran et al has shown history of contact in 30.4% of patients, while Vimlesh seth et al study had shown positive contact history in 19% of children.…”

Section: Discussionmentioning

confidence: 97%