Panigatti Pushpa, Ratageri Vinod Hanumant, Shivanand Illalu, Madhu P K, Shepur T A
Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, 580021, Karnataka, India.
Indian J Pediatr. 2014 Jan;81(1):9-14. doi: 10.1007/s12098-013-1175-8. Epub 2013 Jul 28.
To study the clinical profile and outcome of childhood tuberculosis treated with Directly Observed Treatment Short (DOTS) course regimen. Also to study the side effects of anti-tubercular treatment (ATT).
This prospective hospital based observational study was conducted at Department of Pediatrics, Karnataka Institute of Medical Sciences (KIMS), Hubli. Inclusion criteria were i) All newly diagnosed cases of tuberculosis from 0 to 12 y of age. ii) Children with relapse, treatment failure or defaulters. Exclusion criteria was children with tuberculosis on anti-tubercular treatment (ATT) other than DOTS regimen. A detailed history including demographic profile and clinical examination were carried out for each case. Diagnosis, categorization, treatment (DOTS regimen) and outcome measures were defined according to WHO/RNTCP guidelines. Data was analyzed using SPSS 17.
Total number of children enrolled in the study were 93. Mean age was 6 y. Male to female ratio was 0.9:1. Extra pulmonary tuberculosis (EPTB) was common 58 (62.4 %) than pulmonary tuberculosis 35 (37.6 %). The common symptoms/signs were fever (83.8 %), cough (46.2 %), convulsion (17.2 %), loss of appetite (11.8 %) and pallor (75.3 %), lymphadenopathy (18.3 %), hepatomegaly (9.7 %) and splenomegaly (6.5 %). Mantoux test was positive in 59 (63.4 %) children. Acid fast bacilli (AFB) was isolated in 13 (14 %) children in various fluid/histological specimens. The prevalence of HIV infection was 7.5 %. Among 93 children, 88(94.6 %) completed treatment and were declared cured; four children were lost to follow up and one child died. Compliance of DOTS was good and there were no side effects due to ATT.
EPTB was common than pulmonary TB. Efficacy of DOTS in index study was 94.6 %. No adverse effects of ATT were observed.
研究采用直接观察短程治疗（DOTS）方案治疗儿童结核病的临床特征及转归。同时研究抗结核治疗（ATT）的副作用。
这项基于医院的前瞻性观察性研究在胡布利市卡纳塔克医学科学研究所（KIMS）儿科进行。纳入标准为：i）所有新诊断的0至12岁结核病病例。ii）复发、治疗失败或违约的儿童。排除标准为接受非DOTS方案抗结核治疗（ATT）的结核病儿童。对每个病例进行了详细的病史询问，包括人口统计学资料和临床检查。根据世界卫生组织/修订的国家结核病控制规划（WHO/RNTCP）指南进行诊断、分类、治疗（DOTS方案）和转归测量。使用SPSS 17软件进行数据分析。
纳入研究的儿童总数为93名。平均年龄为6岁。男女比例为0.9:1。肺外结核（EPTB）比肺结核更常见，分别为58例（62.4%）和35例（37.6%）。常见症状/体征为发热（83.8%）、咳嗽（46.2%）、惊厥（17.2%）、食欲不振（11.8%）、面色苍白（75.3%）、淋巴结病（18.3%）、肝肿大（9.7%）和脾肿大（6.5%）。59名（63.4%）儿童结核菌素试验呈阳性。在各种体液/组织学标本中，13名（14%）儿童分离出抗酸杆菌（AFB）。HIV感染率为7.5%。在93名儿童中，88名（94.6%）完成治疗并被宣布治愈；4名儿童失访，1名儿童死亡。DOTS的依从性良好，未观察到ATT引起的副作用。
EPTB比肺结核更常见。本研究中DOTS的有效率为94.6%。未观察到ATT的不良反应。
