Villarreal Enrique G, Ramos-Barrera Emilia, Estrada-Mendizabal Ricardo J, Treviño-Valdez Pablo D, Tamez-Rivera Oscar
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey, N.L. 64710, Mexico.
Department of Pediatrics, Secretaría de Salud del Gobierno del Estado de Nuevo León, Hospital Regional de Alta Especialidad Materno Infantil de Monterrey, Ave. San Rafael 450, Guadalupe, N.L. 67140, Mexico.
J Clin Tuberc Other Mycobact Dis. 2024 Apr 19;36:100441. doi: 10.1016/j.jctube.2024.100441. eCollection 2024 Aug.
Analyzing the epidemiology and clinical manifestations of pediatric tuberculosis in endemic regions is crucial to meet the goal of ending tuberculosis. The objective was to assess the various clinical scenarios of tuberculosis in a large pediatric cohort in Mexico.
This retrospective study from a pediatric referral center in Mexico included patients diagnosed with tuberculosis from 2012 to 2021. We analyzed clinical data and diagnostic study results, including demographic characteristics, underlying medical conditions, BCG vaccination, clinical presentation, imaging findings, microbiologic data, treatment, and clinical outcomes. Basic descriptive statistics and Chi-squared analysis were performed to summarize the metadata of pediatric patients with different clinical presentations of tuberculosis and evaluate their association with mortality, respectively.
A total of 100 patients were included with a mean age of 7.76 years ± 1.49 years. The most prevalent clinical presentation was pulmonary tuberculosis ( 51). Only 51 patients were immunized with Bacillus Calmette-Guérin vaccine. The most commons symptoms were fever, cough and weight loss. Among patients with meningeal tuberculosis ( 14), the most common clinical signs were seizures, fever, and vomiting. Cure was achieved in 52 patients, 12 patients died, and 36 continue in treatment. Clinical presentation of tuberculosis (p-value = 0.009) and immunodeficiency (p-value = 0.015) were significantly associated with mortality.
Increasing the visibility of tuberculosis is imperative to end this disease. We report relevant clinical data of a large pediatric tuberculosis cohort, stratified by the different forms of disease. A high index of suspicion of tuberculosis is required for a timely diagnosis and treatment initiation, particularly among immunocompromised individuals, in whom mortality is higher.
分析结核病流行地区儿童结核病的流行病学和临床表现对于实现终结结核病的目标至关重要。目的是评估墨西哥一个大型儿科队列中结核病的各种临床情况。
这项来自墨西哥一家儿科转诊中心的回顾性研究纳入了2012年至2021年被诊断为结核病的患者。我们分析了临床数据和诊断研究结果，包括人口统计学特征、基础疾病、卡介苗接种情况、临床表现、影像学检查结果、微生物学数据、治疗情况和临床结局。分别进行基本描述性统计和卡方分析，以总结不同临床表现的儿童结核病患者的元数据，并评估它们与死亡率的关联。
共纳入100例患者，平均年龄为7.76岁±1.49岁。最常见的临床表现是肺结核（51例）。只有51例患者接种了卡介苗。最常见的症状是发热、咳嗽和体重减轻。在结核性脑膜炎患者（14例）中，最常见的临床体征是癫痫发作、发热和呕吐。52例患者治愈，12例死亡，36例继续接受治疗。结核病的临床表现（p值=0.009）和免疫缺陷（p值=0.015）与死亡率显著相关。
提高结核病的关注度对于终结这种疾病至关重要。我们报告了一个大型儿童结核病队列的相关临床数据，并按不同疾病形式进行了分层。及时诊断和开始治疗需要对结核病有高度的怀疑指数，特别是在免疫功能低下的个体中，他们的死亡率更高。
