CLINICAL PROFILE AND OUTCOME OF PEDIATRIC TUBERCULOSIS IN A TERTIARY CARE SETTING IN CENTRAL INDIA

Abstract

Objective: To study the clinical profile and outcome of tuberculosis (TB) in children under 14 years of age.

Methods: It is a hospital-based cross-sectional study done in a tertiary referral center in Central India from July 2017 to June 2019. After ethical approval, 80 children (under 14 years of age) diagnosed with presumptive TB were enrolled. Those already on TB treatment or prophylaxis for more than 7 days were excluded from the study. Relevant patient details were noted on a predesigned pro forma. Routine first-line investigations for TB were done in all cases. Histopathological and specific radiology tests were done as per the site involved. Microbiological confirmation was done using microscopy, and molecular diagnosis was done by a cartridge-based nucleic acid amplification test (CBNAAT).

Results: Overall mortality was 13.8%, and 82% of them were children below 5 years of age. As per WHO criteria, 52.5% and 20% of children below 5 years of age were severely and moderately undernourished, respectively. History of contact was present in 66%; BCG scar in 91.3%; and tuberculin sensitivity test positivity in 56% of cases. Fever, cough, and weight loss were the most common presenting complaints. The majority had extrapulmonary involvement (75%), with neurotuberculosis being the most common and with the highest mortality (70%). Microbiological confirmation was possible in only 8.8% of cases.

Conclusion: It is still challenging to diagnose pediatric TB. Though newer diagnostics are now available, clinical suspicion is a valuable tool. The diagnosis of pediatric TB should thus be based on a combination of epidemiological variables, clinical suspicion, and supported by various laboratory investigations.