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Epidemiology of tuberculosis among children in Beijing, China, 2012-2021

Huiwen Zheng¹, Jing Xiao¹, Haiming Yang²

¹Laboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.

Epidemiology and Infection

|March 13, 2024

Insights

Paediatric tuberculosis (TB) trends in China show pulmonary TB (PTB) is more common in younger children, while extrapulmonary TB (EPTB), especially TB meningitis, affects older children. Age and sex influence TB type risk.

Area of Science:

Pediatrics
Infectious Diseases
Epidemiology

Background:

Limited epidemiological data on paediatric tuberculosis (TB) in China.
Understanding clinical and epidemiological profiles is crucial for targeted interventions.

Purpose of the Study:

To investigate the clinical and epidemiological characteristics of diagnosed TB disease and TB infection in children.
To analyze trends in pulmonary TB (PTB) and extrapulmonary TB (EPTB) over time and by age group.

Main Methods:

Retrospective analysis of 3,193 paediatric patients diagnosed with TB disease or infection at Beijing Children's Hospital.
Categorization of TB cases into PTB and EPTB, with further subtyping of EPTB.

Main Results:

Pulmonary TB (PTB) accounted for 51.05% and extrapulmonary TB (EPTB) for 15.16% of cases.
TB meningitis was the most frequent EPTB form (39.05%), particularly in children aged 1-4 years.
PTB risk was higher in younger children (1-4 years), while EPTB risk increased in older children (5-12 years).
Trends showed fluctuations in PTB and EPTB proportions between 2012 and 2021, with a notable increase in TB meningitis.

Conclusions:

Female sex and younger age are associated with higher PTB risk in children.
TB meningitis is the predominant EPTB form in children, with young children being particularly vulnerable.
Age significantly influences the distribution and type of EPTB in paediatric populations.

Read full analysis

Abstract:

Data on epidemiology trends of paediatric tuberculosis (TB) are limited in China. So, we investigated the clinical and epidemiological profiles in diagnosed TB disease and TB infection patients at Beijing Children's Hospital. Of 3 193 patients, 51.05% had pulmonary TB (PTB) and 15.16% had extrapulmonary TB (EPTB). The most frequent forms of EPTB were TB meningitis (39.05%), pleural TB (29.75%), and disseminated TB (10.33%). PTB patients were significantly younger and associated with higher hospitalization frequency. Children aged 1-4 years exhibited higher risk of PTB and TB meningitis, and children aged 5-12 years had higher risk of EPTB. The proportion of PTB patients increased slightly from 40.9% in 2012 to 65% in 2019, and then decreased to 17.8% in 2021. The percentage of EPTB cases decreased from 18.3% in 2012 to 15.2% in 2019, but increased to 16.4% in 2021. Among EPTB cases, the largest increase was seen in TB meningitis. In conclusion, female and young children had higher risk of PTB in children. TB meningitis was the most frequent forms of EPTB among children, and young children were at high risk of TB meningitis. The distribution of different types of EPTB differed by age.

Keywords:

children clinical symptoms epidemiology extrapulmonary tuberculosis pulmonary tuberculosis risk profile

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