Related Experiment Videos
Tuberculous disease in a pediatric referral centre: 16 years experience
N Somu1, D Vijayasekaran, T Ravikumar
1Department of Pediatric Respiratory Diseases, Institute of Child Health, Egmore, Madras.
Insights
Tuberculosis prevalence in children decreased over 16 years. Progressive primary complex rose in BCG-vaccinated children, while other forms were more common in unvaccinated children, with consistent tuberculous meningitis mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly in pediatric populations.
- Understanding the epidemiological trends and clinical manifestations of childhood TB is crucial for effective control strategies.
Purpose of the Study:
- To analyze the trends in various clinical forms of childhood tuberculosis over a 16-year period.
- To investigate the impact of Bacillus Calmette-Guérin (BCG) vaccination on the prevalence and outcomes of different TB forms in children.
Main Methods:
- Retrospective analysis of pediatric TB cases registered at a specialized clinic from 1977 to 1992.
- Comparison of TB prevalence and mortality between BCG-vaccinated and non-vaccinated children.
Main Results:
- Overall childhood TB prevalence declined, but progressive primary complex increased in BCG-vaccinated children.
- Pleural effusion, bone TB, and abdominal TB were more prevalent in unvaccinated children.
- Tuberculous meningitis occurred more frequently in unvaccinated children (1:3 ratio), with consistent mortality rates.
Conclusions:
- Childhood TB epidemiology is evolving, with shifts in the prevalence of specific forms influenced by BCG vaccination status.
- Tuberculous meningitis remains a critical concern with persistent high mortality, irrespective of vaccination status.
- Targeted public health interventions are needed to address the changing patterns of childhood tuberculosis.
Abstract:
Children with evidence of tuberculous disease registered at the TB Clinic, Institute of Child Health, Madras during the years 1977 to 1992 were analyzed. Progressive primary complex, is the commonest thoracic form of tuberculosis while tuberculous meningitis is the commonest extra thoracic form. The overall prevalence of various clinical forms of tuberculosis has decreased over the last 16 years. There is an increasing trend in the prevalence of progressive primary complex among the BCG vaccinated group. The prevalence of pleural effusion, bone tuberculosis and abdominal tuberculosis is almost same over the last 16 years and is more in the BCG non vaccinated children. In tuberculous adenitis there is no significant variation between the two groups. The occurrence of tuberculous meningitis is in the ratio of 1:3 among BCG vaccinated and non-BCG vaccinated children. Though the prevalence of miliary tuberculosis is negligible, it is significantly more in BCG non-vaccinated children. There is a tendency for slight decrease in overall mortality due to tuberculosis in the last 10 years but the mortality due to tuberculous meningitis continues to be the same over the past 16 years.