Ksoo Rosina, Barman Himesh, De Manisha, Lynser Donboklang, Duwarah Sourabh G, Lyngdoh Clarissa
Paediatrics, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.
Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.
Cureus. 2023 May 7;15(5):e38660. doi: 10.7759/cureus.38660. eCollection 2023 May.
Context Tuberculosis (TB) is India's major public health problem. The profile of childhood TB in the northeast region of India is still limited. Aim To analyze the clinical, radiological, and bacteriological profiles of children with TB at a tertiary health care facility. Materials and methods A three years retrospective descriptive analysis of children admitted to a tertiary centre with TB before the introduction of cartridge-based nucleic acid amplification test (CBNAAT) for testing. Children below 18 years who were admitted from 2012 to 2014 and were diagnosed with TB were included. Relevant data were extracted in a predesigned format and entered into a Microsoft Excel sheet. Descriptive statistic was used for analysis. The results of variables are given in proportions and means and a Chi-square test was done for the test of significance using Epi-info tools. The study was done after getting ethical approval from the institute. Results A total of 150 children were included in the analysis with a Male: Female ratio of 1.1:1. A majority of the cases were under five years (n=46) and 11 to 15 years old (n=45) with a mean age of 9.3 ± 4.4 years. Fever was a common presentation (70%). Disseminated TB was seen in 31.3%, isolated central nervous system (CNS) TB was found in 30.6%, and all CNS TB with dissemination was found in 46 cases (40.7%) making extra-pulmonary TB a common finding in our study (83.3%). Isolated pulmonary TB was seen in 16.7% and total pulmonary cases along with dissemination was seen in 60 cases (40%). A bacteriological diagnosis was made in 23%. Overall mortality was 9.3%, out of which mortality in CNS TB was 13% with a p-value of 0.004 as compared to mortality other than CNS TB which was significant and mortality in under-five years was significant with a p-value of 0.001. Conclusions Pulmonary and extra-pulmonary were both causes of admission in the pediatric age group. We found that extra-pulmonary TB was the most common cause of admission in children, with CNS manifestation and disseminated TB, being the most common presentations and significant mortality was seen in under-five years and in children diagnosed with CNS TB.
结核病是印度主要的公共卫生问题。印度东北地区儿童结核病的情况仍然有限。目的：分析一家三级医疗机构中结核病患儿的临床、放射学和细菌学特征。材料与方法：对在引入基于 cartridge 的核酸扩增试验（CBNAAT）进行检测之前入住三级中心的结核病患儿进行为期三年的回顾性描述性分析。纳入 2012 年至 2014 年期间入院且被诊断为结核病的 18 岁以下儿童。以预先设计的格式提取相关数据并录入 Microsoft Excel 工作表。采用描述性统计进行分析。变量结果以比例和均值给出，并使用 Epi - info 工具进行卡方检验以检验显著性。该研究在获得研究所的伦理批准后进行。结果：共有 150 名儿童纳入分析，男女比例为 1.1:1。大多数病例年龄在 5 岁以下（n = 46）和 11 至 15 岁（n = 45），平均年龄为 9.3 ± 4.4 岁。发热是常见症状（70%）。播散性结核病占 31.3%，孤立性中枢神经系统（CNS）结核病占 30.6%，伴有播散的所有 CNS 结核病有 46 例（40.7%），这使得肺外结核病在我们的研究中成为常见发现（83.3%）。孤立性肺结核占 16.7%，伴有播散的所有肺部病例有 60 例（40%）。细菌学诊断率为 23%。总体死亡率为 9.3%，其中 CNS 结核病的死亡率为 13%，与非 CNS 结核病的死亡率相比，p 值为 0.004，具有显著性，5 岁以下儿童的死亡率具有显著性，p 值为 0.001。结论：在儿童年龄组中，肺部和肺外疾病都是入院原因。我们发现肺外结核病是儿童入院的最常见原因，中枢神经系统表现和播散性结核病是最常见的症状，5 岁以下儿童以及被诊断为 CNS 结核病的儿童死亡率较高。
