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Clinical Characteristics and Risk Factors of Tuberculosis in Children and Adolescents in Xinjiang, China: A
Tao Xin1, Gaofeng Sun2, Jiangbutaer Entemake2
1Department of Pediatrics, The Infectious Disease Hospital of Xinjiang Uygur Autonomous Region, The Sixth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830049, China.
Insights
Pediatric tuberculosis (TB) in Xinjiang shows a high rate of extrapulmonary TB (EPTB), especially tuberculous meningitis in young children. Early diagnosis and better tools are crucial for improving outcomes in children with TB.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) is a significant global health issue, particularly in high-incidence regions.
- Xinjiang, China, has the highest TB rates nationally, yet pediatric TB data is scarce.
- Understanding pediatric TB in Xinjiang is vital for targeted public health interventions.
Purpose of the Study:
- To investigate the clinical and epidemiological characteristics of pediatric tuberculosis in Xinjiang.
- To identify risk factors associated with extrapulmonary TB (EPTB) and severe TB in children.
- To evaluate diagnostic tool performance in pediatric TB cases.
Main Methods:
- A retrospective cross-sectional study analyzed data from 253 pediatric TB patients (≤17 years) hospitalized in Xinjiang from 2020-2022.
- Demographic, clinical, and laboratory data were collected and analyzed.
- Risk factors for EPTB and severe TB were assessed.
Main Results:
- Extrapulmonary TB (EPTB) accounted for 45.1% of cases, with tuberculous meningitis (TBM) being the most common form (40.4% of EPTB).
- EPTB was more prevalent in children under 5 years old.
- Younger age, rural residence, and lack of BCG vaccination increased EPTB risk. Tuberculin skin test and interferon-γ release assay showed high positivity, while smear microscopy and Xpert MTB/RIF had low yields, especially for EPTB.
Conclusions:
- Pediatric TB in Xinjiang is marked by a substantial burden of EPTB, particularly TBM in young children.
- Effective early diagnosis and improved access to diagnostic tools are critical for reducing pediatric TB morbidity.
- Targeted strategies are needed to address the unique challenges of pediatric TB in this high-burden region.
Abstract:
Background: Tuberculosis (TB) remains a major public health challenge among children and adolescents in high-burden countries. Xinjiang, the region with the highest TB incidence in China, has limited data on the clinical and epidemiological characteristics of pediatric TB. Methods: We conducted a retrospective cross-sectional study of children and adolescents (≤17 years) hospitalized with TB at a regional referral hospital in Xinjiang between 1 January 2020 and 31 December 2022. Demographic, clinical, and laboratory data were analyzed, and risk factors for extrapulmonary TB (EPTB) and severe TB were assessed. Results: A total of 253 patients were included, of whom 54.9% (139/253) had pulmonary TB (PTB) and 45.1% (114/253) had EPTB. EPTB was more common among children <5 years (78.9%, 15/19). The predominant clinical symptoms were fever (55.7%, 141/253), cough (66.8%, 169/253), fatigue (60.9%, 154/253), and night sweats (51.8%, 131/253). Tuberculous meningitis (TBM) was the most frequent EPTB manifestation (40.4%, 46/114). Younger age, rural residence, and absence of BCG vaccination were associated with a higher risk of EPTB. Laboratory findings showed high positivity rates for tuberculin skin test (96.1%, 99/103) and interferon-γ release assay (84.5%, 196/232), but low yields for smear microscopy and Xpert MTB/RIF, especially in EPTB cases. Conclusions: Pediatric TB in Xinjiang is characterized by a high burden of EPTB, particularly TBM in young children. Strengthening early diagnosis and improving access to effective diagnostic tools are essential to reduce morbidity and improve outcomes in this vulnerable population.
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