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

Abstract

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.

Characteristics of Tuberculosis among Children and Adolescents at a Referral TB’s Hospital, 2006 - 2011

“…In a recent study in China out of 1212 children aged 0 -18 years, the most common types of extrapulmonary TB were TB meningitis and disseminated TB which most pediatric patients with EPTB aged less than five years old. They concluded that pediatric cases with the history of close contact with TB infected patients and no Bacillus Calmette-Guerin (BCG) vaccination might have a higher risk of severe TB (20). Thus, BCG vaccination at birth and better detection of TB-infected children with contact to adult patients with TB can help to prevent extrapulmonary and severe TB in young children (21).…”

Pattern of childhood tuberculosis among the patients admitted in Dhaka Shishu (Children) Hospital

“…13 In this study majority of EPTB cases were tubercular meningitis which comprised 27.87%. A recent studies from China reported the incidence of TB meningitis as 38.8% in TB 14 Infants and young children are more likely than older children and adults to develop life-threatening forms of TB disease (i.e., disseminated TB and TB meningitis), and because of their age, pediatric TB acts as a surrogate for identifying recent transmission. 15 In this study case fatality rate was (13 cases) 14.29%.…”

Meningoencefalitis tuberculosa en niños. Experiencia en el Instituto Nacional de Salud del Niño de Lima, 2009 – 2013

“…Además se observó el bajo aislamiento del Bacilo de Koch y ningún caso positivo a la tinción de ZiehlNeelsen (ZN) en el LCR, estudios previos describen entre 14,4 % y 35,1% de cultivos positivos y 3,5% a 10% positivos a la tinción de ZN (3,7,10,24,25). Es posible incrementar la identificación del bacilo de Koch con mayor volumen y concentrando la muestra de LCR (7,15).…”