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Growth and anemia among children with tuberculosis infection at different sites in Southwest China
Zhongmin Gao1, Quanbo Liu2, Qin Deng1
1Department of Nutrition, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Tuberculosis (TB) in children significantly impacts growth and increases anemia risk, particularly with disseminated disease. Poor nutritional status, a key factor, can lead to treatment abandonment.
Area of Science:
- Pediatric infectious diseases
- Nutritional science
- Public health
Background:
- Tuberculosis (TB) poses a significant health challenge globally, especially in children.
- Understanding the impact of TB site on pediatric health indicators is crucial for effective management.
Purpose of the Study:
- To investigate the effects of TB infection at various sites on anthropometric indicators, malnutrition, and anemia in children.
- To identify risk factors associated with growth disorders and anemia in pediatric TB patients.
Main Methods:
- A cohort of 368 children (1 month to 16 years) with TB were classified into tuberculous meningitis (T), T with pulmonary TB (TP), and T with pulmonary and abdominal TB (TPA) groups.
- Anthropometric measurements (weight, height), nutritional risk, and biochemical indicators (hemoglobin, albumin) were collected upon admission.
Main Results:
- The TPA group showed the lowest body mass index-for-age z-score (BAZ), height-for-age z-score (HAZ), hemoglobin (Hb), and albumin (ALB) levels.
- Malnutrition prevalence was highest in the TPA group (69.5%) and in children aged 10–16 years (72.4%).
- Anemia prevalence was highest in children aged 0.5–2 years (70.6%) and in the TPA group (70.5%).
Conclusions:
- Children with tuberculous meningitis are at high risk for growth disorders and anemia, exacerbated by pulmonary and abdominal TB complications.
- Specific age groups (0.5–2 years for anemia, 10–16 years for malnutrition) and disease extent (TPA) are particularly vulnerable.
- Nutritional status is a significant factor influencing treatment adherence and outcomes in pediatric TB.
Objectives:
To explore the effects of tuberculosis (TB) infection at different sites on anthropometric indicators, malnutrition and anemia incidence in children in Southwest China.
Methods:
From January 2012 to December 2021, a total of 368 children aged 1 month to 16 years were enrolled. According to the sites of TB infection, they were divided into three groups: tuberculous meningitis (T group), tuberculous meningitis complicated withpulmonary tuberculosis (TP group), and tuberculous meningitis complicated with pulmonary tuberculosis and abdominal tuberculosis (TPA group). Data on weight, height, nutritional risk, blood biochemical indicators and basic descriptions were collected within 48 h after admission.
Results:
The body mass index-for-age z score (BAZ), height-for-age z score (HAZ), and concentrations of hemoglobin (Hb) and albumin (ALB) decreased in the following order: T group, TP group, and TPA group. The prevalence of malnutrition was the highest in the TPA group (69.5%, 82/118) and 10-to 16-year-old group (72.4%, 63/87). Children aged 0.5-2 years exhibited the highest anemia prevalence of 70.6% (48/68) among the four age groups.The TPA group had the highest incidence of anemia (70.5%, 67/95) compared to T group and TP group.Compared with the treatment group, the abandonment group had a lower BAZ, HAZ and levels of HB and ALB, a higher rate of severe malnutrition, and higher nutritional risk scores. Children who had a low BAZ [odds ratio (OR) = 1.98], nutritional risk (OR = 0.56) and anemia (OR = 1.02) were less likely to obtain treatment with their guardians' support.
Conclusions:
Children with tuberculous meningitis were at risk for growth disorders and anemia, especially when complicated with pulmonary tuberculosis and abdominal tuberculosis. The prevalence of anemia and malnutrition was the highest among patients aged 1 month to 2 years and 10-16 years, respectively. Nutritional status was one of the causes of abandoning treatment.
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