Tuberculosis in Children With Primary Immunodeficiencies: A 13-Year Retrospective Experience

Area of Science:

• Pediatric Infectious Diseases
• Immunology
• Public Health

Background:

• Host immune status is a primary determinant of tuberculosis (TB) progression.
• Reports of TB in children with primary immunodeficiency (PID), or inborn errors of immunity (IEI), are infrequent.
• This study examines the impact of PID/IEI on childhood TB.

Purpose of the Study:

• To describe the impact of PID/IEI on childhood TB disease.
• To highlight the importance of investigating PID in pediatric TB patients.

Main Methods:

• A retrospective cohort study of 217 TB patients aged 1 month to 18 years (January 2012-January 2025).
• TB patients were compared based on PID status.
• Radiological, histopathological, microbiological, clinical, and treatment data were analyzed for PID patients.

Main Results:

• PID was identified in 5.5% of TB patients; 50% of these had undiagnosed immunodeficiency prior to TB diagnosis.
• PID patients were significantly younger (median 17 months) than non-PID patients (p=0.001).
• Extrapulmonary TB was more common in PID patients (p=0.049); treatment duration was 6-24 months with no mortality.

Conclusions:

• Investigating PID in children with TB is crucial for early diagnosis and treatment, preventing fatal complications.
• Expanding immunological investigations can enhance understanding of childhood TB pathogenesis.