Prevalence of Tuberculosis in Severe Acute Malnutrition: A Prospective Observational Study

Thakur, Jitendra; Thakur, Ranjana; Bhatta, Narendra; Yadav, Suman; Khanal, Basudha; Bhattarai, Narayan

doi:10.3126/jnps.v42i1.39974

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Our prevalence was higher than that reported in India (13%) (16), in Nepal (4.67%) (17), in Ethiopia (10.39%) (13) and in Congo (8.4%) (18), but slightly lower than that reported in South Africa (25.6%) (19). The differences in the prevalence of tuberculosis can be attributed to the study population differences since the burden of tuberculosis varies geographically, but also the criteria used for diagnosis of tuberculosis in these studies.…”

Section: Discussioncontrasting

confidence: 82%

Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Asiimwe,

Ndezi,

Nduwimana

et al. 2024

Preprint

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Background Although treatable, pulmonary tuberculosis (PTB) has a significant morbidity and mortality. Children with malnutrition are immune compromised, which increases the morbidity and mortality of PTB. This study was done to determine the prevalence and factors associated with Tuberculosis among children aged 6 to 59 months admitted with severe acute malnutrition (SAM) at Jinja Regional Referral Hospital (JRRH). Methods This was a cross–sectional study among children aged 6-59 months with SAM at JRRH. History was taken and physical examination done. Gene Xpert was done for all participants, Lipoarabinomannan Antigen Assay for TB (TB-LAM) done for HIV positive children with CD4 below 200 and Chest X-ray for children who presented with cough and difficulty in breathing. Both the investigations and clinical findings were used to make a diagnosis of PTB. Using binary logistic regression in SPSS, the factors associated with Tuberculosis were determined. P value <0.05 was considered significant. Results Of the 137 children enrolled with SAM, majority were in the age groups of 6-11 and 12-23 months. Non-edematous malnutrition was the commonest 73(53.3%). Thirty-two children were diagnosed with TB with a prevalence of 23.4%. Of the 32 diagnosed with Tuberculosis, only 5 had a positive gene expert test, 2 had a positive urine TB LAM and the remaining 25 were diagnosed using the clinical criteria. The commonest symptoms among children diagnosed with TB were cough seen in 25/32 (78.1%) and fever in 24/32 (75%). The most common radiological findings comprised adenopathy (64.3%) and consolidations (49.7%). Coming from rural areas (aOR=1.205, 95%CI=1.067-1.360, P=0.003), being HIV positive (aOR=1.619, CI=1.114-2.354, P=0.012), thrombocytopenia (aOR=1.407, CI=1.069-1.853, P=0.015) and thrombocytosis (aOR=1.202, CI=1.047-1.379, P=0.009) were independently associated with presence of Tuberculosis. Conclusion The prevalence of tuberculosis in Severe Acute Malnutrition was high. Children with SAM should be routinely screened for TB. When resources are constrained, the iinvestigations for TB could be focused on those coming from rural areas, the HIV positive, those with thrombocytopenia and those with thrombocytosis.

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Section: Discussioncontrasting

confidence: 82%

Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Asiimwe,

Ndezi,

Nduwimana

et al. 2024

Preprint

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“…The prevalence of TB in children diagnosed with SAM was 4.67% from the study done in Nepal, 4 22% from the study done in Rewa, 5 20% from the study done in Ola, 6 and 56% from the study done in Arua Regional Referral Hospital. 7 The prevalence of TB in under 5 years old children’s diagnosed with SAM was 10.39% in a study done in Ethiopia.…”

Section: Introductionmentioning

confidence: 91%

Survival Status and Predictors of Tuberculosis Development Among Under 5 Children Admitted With Severe Acute Malnutrition in Ethiopia: A Retrospective Cohort Study

Wake

2024

Global Pediatric Health

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Introduction. The burden of severe acute malnutrition (SAM) remains unacceptably high worldwide. The burden of Tuberculosis (TB) co-occurring with SAM in under 5 children is a significant focus for the improvement of child health. The co-existence of these diseases are significantly enhancing the associated morbidity, mortality, and hospitalization costs among this population. Objective. To determine survival status and predictors of TB development in under 5 children with SAM in Asella Referral and Teaching Hospital, Ethiopia. Methods. A retrospective cohort study was done in 247 under 5 children with SAM between January 01/2018 and December 31/2022. Systematic sampling technique was used to select the study participants. Data extraction format was used to collect data from the patient’s medical chart. EpiData version 4.6.0.6 was used for data entry and exported to STATA version 14.2 for statistical analysis. Result. This study includes 247 under 5 children with SAM with a response rate of 100%. Regarding to the survival status; 24(17%) of under 5 children with SAM have developed the events (TB) and the rest of them, 205(83%) were censored. The incidence density rate (IDR) of TB in under 5 children with SAM was 45.51 per 100 (95% CI: 33.63, 61.58) children-months observation. The cumulative incidence of TB was 17% (95% CI: 12.79, 22.25). Multivariable Cox proportional hazard analysis revealed that: having a history of TB contact (AHR = 5.56, 95% CI: 2.77, 11.15, P-value = .000), having a history of bottle feeding (AHR = 4.95, 95%CI: 1.08, 22.77, P-value = .040), did not take F100 (AHR = 1.71, 95% CI: 1.12, 7.25, P-value = .00) were statistically significant predictors of TB development. Conclusion. This study shows that the IDR of TB was high. Having a history of TB contact, history of bottle feeding, and not taking F100 were significant predictors of TB development. It is vital to address these predictors to prevent the development of TB in this population. Moreover, early screening of TB in these children should get high emphasize.

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Prevalence of Tuberculosis in Severe Acute Malnutrition: A Prospective Observational Study

Cited by 2 publications

References 9 publications

Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: A crossectional study in Uganda

Survival Status and Predictors of Tuberculosis Development Among Under 5 Children Admitted With Severe Acute Malnutrition in Ethiopia: A Retrospective Cohort Study

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