Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
J Pediatric Infect Dis Soc. 2022 Jul 21;11(7):329-336. doi: 10.1093/jpids/piac029.
Data are limited on the resolution of symptoms and signs in children treated for pulmonary tuberculosis (PTB) and whether this resolution differs from children with other lower respiratory tract infections (LRTIs).
A prospective study of children ≤ 15 years presenting with features suggestive of PTB was performed. Clinical, microbiological, and radiological investigations were done at enrollment. Symptoms and clinical features were measured 1, 3, and 6 months after enrollment. Participants were categorized into 3 groups based on National Institutes of Health consensus definitions: confirmed PTB, unconfirmed PTB, and unlikely PTB (children with other LRTIs). Univariable and multivariable logistic regression modeling was used to investigate predictors of persistence of symptoms or signs.
Among 2019 participants, there were 427 (21%) confirmed, 810 (40%) unconfirmed, and 782 (39%) with unlikely PTB. Of 1693/2008 (84%) with cough and 1157/1997 (58%) with loss of appetite at baseline, persistence at 3 months was reported in 24/1222 (2%) and 23/886 (3%), respectively. Of 934/1884 (50%) with tachypnoea and 947/1999 (47%) with abnormal auscultatory findings at baseline, persistence at 3 months occurred in 410/723 (57%) and 216/778 (28%), respectively. HIV infection and abnormal baseline chest radiography were associated with persistence of symptoms or signs at month 3 (adjusted odds ration [aOR] 1.6; 95% confidence interval [CI]: [1.1, 2.3] and aOR 2.3; 95% CI: [1.5, 3.3], respectively]. The resolution of symptoms and signs was similar across categories.
Symptoms resolved rapidly in most children with PTB, but signs resolved more slowly. The pattern and resolution of symptoms or signs did not distinguish children with PTB from those with other LRTIs.
关于接受肺结核（PTB）治疗的儿童症状和体征的缓解情况的数据有限，且尚不清楚这种缓解是否与患有其他下呼吸道感染（LRTIs）的儿童不同。
对有疑似肺结核表现的≤15 岁儿童进行了一项前瞻性研究。在入组时进行了临床、微生物学和影像学检查。在入组后 1、3 和 6 个月测量症状和临床特征。根据美国国立卫生研究院共识定义，将参与者分为 3 组：确诊肺结核、未确诊肺结核和不太可能患有肺结核（患有其他 LRTIs 的儿童）。采用单变量和多变量逻辑回归模型来研究症状或体征持续存在的预测因素。
在 2019 名参与者中，有 427 名（21%）确诊为肺结核，810 名（40%）未确诊为肺结核，782 名（39%）不太可能患有肺结核。在 1693/2008 名（84%）有咳嗽和 1157/1997 名（58%）有食欲不振的患者中，分别有 24/1222（2%）和 23/886（3%）在 3 个月时报告症状持续存在。在基线时有 934/1884 名（50%）呼吸急促和 947/1999 名（47%）听诊异常的患者中，分别有 410/723（57%）和 216/778（28%）在 3 个月时报告症状持续存在。HIV 感染和基线异常胸部 X 线片与 3 个月时症状或体征持续存在相关（调整后的优势比[aOR] 1.6；95%置信区间[CI]：[1.1, 2.3]和 aOR 2.3；95%CI：[1.5, 3.3]）。症状和体征的缓解情况在各分类中相似。
大多数患有肺结核的儿童的症状迅速缓解，但体征缓解较慢。症状或体征的模式和缓解情况并不能将患有肺结核的儿童与患有其他 LRTIs 的儿童区分开来。
