Epidemiological Trends in the Form of Childhood Tuberculosis in a Referral Tuberculosis Hospital in Shandong, China

Abstract

Background. In China, the prevalence of tuberculosis (TB) diseases and epidemiological trends in the TB forms among children are still unclear; a retrospective study was conducted aiming to assess it. Methods. Between January 2007 and September 2020, 1577 consecutive childhood TB patients (aged ≤ 15 years) were included in the study. Data, including demographic information and underlying diseases, were collected from medical records. Then, patients were categorized and reported according to the anatomical site of TB disease. To analyze the epidemiological trends in the proportion of each form of TB disease, a linear-by-linear association was used, and a P value of <0.05 was considered to indicate that a significant change had occurred in the proportion of TB disease over the studied period. Results. During the fourteen-year study period, a total of 1577 children patients were enrolled, including 954 boys (60.5%) and 623 girls (39.5%), with a mean age of 9.26±5.18 years. Among the studied patients, 810 (51.4%) patients have pulmonary TB, 1137 (72.1%) have extrapulmonary TB, 372 (23.6%) have both conditions, and another 765 (48.5%) extrapulmonary cases presented in isolated form. Pleural TB (29.0%) and tuberculous lymphadenitis (23.7%) were the most frequent two forms of childhood TB. In addition, during the past decade, the proportions of pulmonary TB, pleural TB, and tuberculous lymphadenitis showed an increasing trend (all P<0.05). However, no significant trends in the proportions of other forms of TB disease, such as extrapulmonary TB (P>0.05), tuberculous meningitis (P>0.05), endobronchial TB (P>0.05), and disseminated TB (P>0.05), were found. Conclusion. Our findings suggest that childhood TB is facing new challenges, and the policy should be adjusted timely to fit the real situation.

Epidemiology of extrapulmonary tuberculosis among pediatric inpatients in mainland China: a descriptive, multicenter study

“…Nearly 46% of children in this study exhibited EPTB or combined TB; this was higher than the proportions in the UK (38.11%)[ 17 ], Colombia (34.41%)[ 18 ], Italy (30.87%)[ 19 ], Turkey (30.50%)[ 20 ], the USA (24.52%)[ 21 ], and India (17.68%)[ 22 ]. Previous studies of Chinese pediatric TB patients from Beijing Children’s Hospital and Shandong Chest Hospital showed that the overall proportions of pediatric TB patients with extrapulmonary infection were 54% and 73%, respectively[ 12 , 13 ]. A plausible explanation for the differences between the present and previous studies was that both previous studies used single-centre designs and were conducted at high-level hospitals in the eastern part of China which had relatively better medical diagnosis and treatment capabilities countrywide.…”

“…A descriptive study of 1212 patients aged 0–18 years with TB (655 cases with extrapulmonary infection, 54%) was conducted from January 2002 to December 2010 in Beijing Children’s Hospital [ 12 ]. Another study analyzed 1577 consecutive patients with pediatric TB (1137 cases with extrapulmonary infection, 73%) at a Referral Tuberculosis Hospital in Shandong Province [ 13 ]. However, multicenter pediatric EPTB data remain unavailable in China.…”

The Sensitivity of Diagnostic Criteria of Marais S, et al. in Confirmed Childhood Tuberculous Meningitis

“…Tuberculous meningitis (TBM) is an ongoing serious threat to child health. In China, 9.4% of children with tuberculosis (TB) are diagnosed with TBM, with 14.7% showing poor outcomes, such as death and transferred to a high care center ( 1 , 2 ). Diagnostic delay is an important contributor to mortality in childhood-associated TBM ( 3 ).…”

Loculations and Associated Risk Factors of Childhood Pleural Tuberculosis

“…In addition, childhood TB is known as a paucibacillary form of TB disease and children might have extrapulmonary TB ( 2 , 3 ), make the TB control in children more complicated. As a common extrapulmonary TB in adulthood, pleural TB was also present in children ( 4 ). In addition, unfortunately, during the past decade, the proportion of pleural TB among childhood TB showed an increasing trend ( 4 ).…”

“…As a common extrapulmonary TB in adulthood, pleural TB was also present in children ( 4 ). In addition, unfortunately, during the past decade, the proportion of pleural TB among childhood TB showed an increasing trend ( 4 ). However, on the other side, the good news is that its overall treatment completion rate was up to 94.3% and no deaths ( 5 ).…”