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Clinical and radiological profile of tuberculosis and treatment outcome in patients ≤18 years: A prospective study
Kolla Madhuri1, Saswat Subhankar2, Amrut K Mohapatra2
1Department of Respiratory Medicine, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India.
Insights
Diagnosing tuberculosis in children is challenging, but a combination of clinical signs, symptoms, and radiology aids diagnosis. Treatment outcomes vary, and patient education on completing therapy is crucial for managing childhood tuberculosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) significantly impacts child morbidity and mortality, particularly in endemic regions.
- Diagnosing TB in pediatric populations presents unique challenges.
- Treatment outcomes for childhood TB are often variable.
Purpose of the Study:
- To identify diverse presentations of tuberculosis in children up to 18 years old.
- To characterize clinical, radiological, and microbiological features of pediatric TB.
- To evaluate treatment outcomes in pediatric TB patients.
Main Methods:
- Prospective study design including newly diagnosed pulmonary or extrapulmonary TB cases in patients ≤18 years.
- Utilized detailed history, physical examination, AFB smear, CBNAAT, and radiology for diagnosis.
- Conducted follow-up assessments throughout treatment phases.
Main Results:
- 105 pediatric TB cases were analyzed, with the 7-14 year age group being most affected.
- Pulmonary TB (35.2%) and TB lymphadenitis (31.4%) were the most common diagnoses.
- Microbiological confirmation was achieved in 50.47% of cases; adverse events were generally mild.
Conclusions:
- Integrating clinical, symptomatic, and radiological findings improves pediatric TB diagnosis.
- Recommended TB treatment regimens demonstrate a low risk of severe adverse events in children.
- Educating children and families about TB and treatment adherence is essential.
Background:
Tuberculosis is an important cause of morbidity and mortality in children, especially in endemic countries. The diagnosis of tuberculosis in these patients is challenging due to various reasons. The outcome of treatment in these patients is also varied.
Aims And Objectives:
Our study aims to determine the various types of presentations of tuberculosis; describe the clinical, radiological and microbiological characteristics and also study the outcome of treatment in patients ≤ 18 years of age.
Materials And Methods:
It was a prospective study. We included all newly diagnosed consecutive cases of pulmonary or extra pulmonary TB in patients (up to 18 years of age). After a detailed history and complete physical examination, AFB smear and CBNAAT of samples and radiology were performed. Follow-up of all cases was done at the end of intensive phase (IP) and at the end of treatment or at any time as needed. All statistical analyses were performed using SPSS version 19.0.
Results:
A total of 105 cases were included in our study. Most cases belonged to the age group of 7-14 yrs. Pulmonary tuberculosis (PTB) was diagnosed in 37 cases (35.2%), followed by TB lymphadenitis (31.4%). Microbiological confirmation could be obtained only in 53 cases (50.47%). Joint pain and a derangement in liver function test were the most common adverse effects (4 cases) and 1 case developed optic atrophy.
Conclusion:
A combination of history, signs and symptoms, and radiology may help reach a diagnosis in children. The risk of serious adverse events in children associated with the use of the recommended treatment regimens is also very low. Children and their family members should be educated about TB and the importance of completing treatment.
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