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Pediatric Tuberculosis in a Northeast State of Peninsular Malaysia: Diagnostic Classifications and Determinants
Hafizuddin Awang1, Nik Rosmawati Nik Husain1, Hasniza Abdullah2
1Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Insights
Pediatric tuberculosis constitutes 8.4% of cases in Kelantan, with pulmonary TB being most common. Factors like older age, Malay ethnicity, and non-urban residence significantly influence pediatric tuberculosis disease.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly affecting vulnerable pediatric populations.
- Understanding the epidemiology and risk factors of pediatric TB is crucial for effective control strategies.
Purpose of the Study:
- To determine the proportion of pediatric tuberculosis cases in Kelantan, Malaysia (2012-2015).
- To characterize pediatric TB by anatomical location and sputum smear status.
- To identify sociodemographic and clinical factors associated with TB disease in children.
Main Methods:
- A comparative cross-sectional study utilizing the Tuberculosis Information System.
- Inclusion of all notified pediatric TB cases meeting study criteria.
- Descriptive statistics and logistic regression analyses were employed.
Main Results:
- Pediatric TB accounted for 8.4% (456/5412) of total cases, with a mean age of 15.9 years.
- Pulmonary TB was predominant (78.1%), with 64.9% of these being sputum smear-positive.
- Significant factors associated with pediatric TB included older age, Malay ethnicity, female gender, non-urban residence, and cigarette smoking.
Conclusions:
- The findings provide insights into pediatric TB epidemiology in Kelantan.
- Results can inform local TB detection and control management practices.
- May guide national TB programs in refining detection criteria.
Objectives:
We sought to determine the total proportion of pediatric tuberculosis cases, characterize tuberculosis by its anatomical location and pretreatment sputum smear status, and to determine the association of the sociodemographic and clinical factors with tuberculosis disease among pediatric patients in Kelantan from 2012 until 2015.
Methods:
We conducted a comparative cross-sectional study between tuberculosis cases and tuberculosis contacts among pediatric patients using the Tuberculosis Information System as a source population. All notified cases that fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics, simple and multiple logistic regressions were used for data analysis.
Results:
Of 5412 tuberculosis cases, 456 (8.4%) were pediatric patients with a mean age of 15.9 years. The majority had the pulmonary form of tuberculosis (78.1%) followed by the extrapulmonary (14.9%) and pulmonary form with concomitant extrapulmonary (7.0%) forms. Of all pulmonary tuberculosis cases, 64.9% were sputum smear-positive, and 35.1% were sputum smear-negative. Among 322 pediatric patients with tuberculosis, the majority were Malay (90.7%), 8.4% were illiterate, and 79.5% resided in non-urban areas. Of all cases, 2.8% were HIV-positive, and 14.6% were cigarette smokers. Older age, Malay ethnicity, female gender, non-urban residence, good education level, and cigarette smoking were the significant associated factors for tuberculosis disease among pediatric patients with an adjusted odds ratio (aOR) of 1.41 (95% confidence interval (CI): 1.29-1.54; p < 0.001), 0.17 (95% CI: 0.07-0.44; p < 0.001), 1.88 (95% CI: 1.33-2.65; p < 0.001), 1.92 (95% CI: 1.33-2.79; p = 0.001), 0.20 (95% CI: 0.12-0.33; p < 0.001), and 3.35 (95% CI: 1.86-6.01; p < 0.001), respectively.
Conclusions:
The study will assist practices of tuberculosis detection and control management in the local setting and may help other national tuberculosis programs to review their detection criteria with similar statistics.
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