Awang Hafizuddin, Nik Husain Nik Rosmawati, Abdullah Hasniza
Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Tuberculosis and Leprosy Control Unit, Kelantan State Health Department, Kelantan, Malaysia.
Oman Med J. 2019 Mar;34(2):110-117. doi: 10.5001/omj.2019.22.
We sought to determine the total proportion of pediatric tuberculosis cases, characterize tuberculosis by its anatomical location and pretreatment sputum smear status, and to determine the association of the sociodemographic and clinical factors with tuberculosis disease among pediatric patients in Kelantan from 2012 until 2015.
We conducted a comparative cross-sectional study between tuberculosis cases and tuberculosis contacts among pediatric patients using the Tuberculosis Information System as a source population. All notified cases that fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics, simple and multiple logistic regressions were used for data analysis.
Of 5412 tuberculosis cases, 456 (8.4%) were pediatric patients with a mean age of 15.9 years. The majority had the pulmonary form of tuberculosis (78.1%) followed by the extrapulmonary (14.9%) and pulmonary form with concomitant extrapulmonary (7.0%) forms. Of all pulmonary tuberculosis cases, 64.9% were sputum smear-positive, and 35.1% were sputum smear-negative. Among 322 pediatric patients with tuberculosis, the majority were Malay (90.7%), 8.4% were illiterate, and 79.5% resided in non-urban areas. Of all cases, 2.8% were HIV-positive, and 14.6% were cigarette smokers. Older age, Malay ethnicity, female gender, non-urban residence, good education level, and cigarette smoking were the significant associated factors for tuberculosis disease among pediatric patients with an adjusted odds ratio (aOR) of 1.41 (95% confidence interval (CI): 1.29-1.54; < 0.001), 0.17 (95% CI: 0.07-0.44; < 0.001), 1.88 (95% CI: 1.33-2.65; < 0.001), 1.92 (95% CI: 1.33-2.79; 0.001), 0.20 (95% CI: 0.12-0.33; < 0.001), and 3.35 (95% CI: 1.86-6.01; < 0.001), respectively.
The study will assist practices of tuberculosis detection and control management in the local setting and may help other national tuberculosis programs to review their detection criteria with similar statistics.
我们试图确定儿童结核病病例的总比例，按解剖位置和治疗前痰涂片状况对结核病进行特征描述，并确定2012年至2015年吉兰丹州儿童患者中社会人口统计学和临床因素与结核病的关联。
我们以结核病信息系统作为源人群，对儿童患者中的结核病病例与结核病接触者进行了一项比较横断面研究。所有符合纳入和排除标准的报告病例均纳入研究。采用描述性统计、单因素和多因素逻辑回归进行数据分析。
在5412例结核病病例中，456例（8.4%）为儿童患者，平均年龄15.9岁。大多数为肺结核（78.1%），其次是肺外结核（14.9%）和合并肺外结核的肺结核（7.0%）。在所有肺结核病例中，64.9%痰涂片阳性，35.1%痰涂片阴性。在322例儿童结核病患者中，大多数是马来人（90.7%），8.4%为文盲，79.5%居住在非城市地区。在所有病例中，2.8%为艾滋病毒阳性，14.6%为吸烟者。年龄较大、马来族裔、女性、非城市居住、教育水平良好和吸烟是儿童结核病患者结核病的显著相关因素，调整后的优势比（aOR）分别为1.41（95%置信区间（CI）：1.29 - 1.54；P < 0.001）、0.17（95% CI：0.07 - 0.44；P < 0.001）、1.88（95% CI：1.33 - 2.65；P < 0.001）、1.92（95% CI：1.33 - 2.79；P = 0.001）、0.20（95% CI：0.12 - 0.33；P < 0.001）和3.35（95% CI：1.86 - 6.01；P < 0.001）。
该研究将有助于当地结核病检测和控制管理工作，并可能有助于其他国家结核病项目参考类似统计数据来审查其检测标准。
