CLINICOPATHOLOGICAL PROFILE OF CHILDREN EVALUATED FOR SUSPECTED UBERCULOSIS IN A RURAL MEDICAL COLLEGE HOSPITAL

Padma Kalyanaraman, Sumathi S
2019 Indian Journal of Child Health  
I t is estimated that nearly 10 million people developed tuberculosis (TB) worldwide in the year 2017, of which nearly 1 million were children [1] . In general, the emphasis is largely focused on the adult disease, whereas the TB in children is relatively neglected mainly due to greater challenges in diagnosis and the comparatively less priority attributed to children by the various TB control programs. As a result of these factors, research and data associated with cases of childhood TB are
more » ... childhood TB are limited. Childhood TB presents itself as a major challenge due to the method it has been explored till date. Childhood TB is considered as a marker of recent transmission in the community and a pool for future adult cases also [2] . The plan of action to reduce the incidence rate of morbidity and mortality occurring due to childhood TB is to design effective methods of diagnosis at the early stages of the infection, tracing of contacts in addition to designing of an effective treatment regimen. The non-specific nature of the sign and symptoms, the paucibacillary nature of the disease, and the low specificity of available diagnostic tests contribute vastly to make the cases of childhood TB a daunting task for the clinicians [3]. Differences in the pathophysiology and clinical representation of TB in children make the process of diagnosis more challenging in comparison to adults in addition to non-definitive modes of latent infection and disease are less understood. Following infection, several factors appear to influence the balance of risk between latent TB and progression to active disease. The several factors included are age, nutritional status, vaccination, and immune status [2, 3] . Children are at much higher risk of progression into active diseases in comparison to adults. The risk is higher in the cases of infants and children below 2 years to age. The objective of the present study was to analyze the various symptoms and signs of clinically suspected TB among children as per updated guidelines for pediatric TB 2012 [4] and correlate with the laboratory findings to identify the most useful diagnostic parameters to confirm the clinical diagnosis of TB. MATERIALS AND METHODS This was a retrospective study carried out in a rural tertiary health care hospital for a period of 1 year from ABSTRACT Background: Tuberculosis (TB) is a major public health problem all over the world and India accounts for nearly one-third of the world TB burden. Pediatric TB has been estimated to account for approximately 20-40% of the cases in India. However, the diagnosis of childhood TB remains a challenge and is a major cause of concern in the eradication of TB. Objectives: The objectives of this study were to study the various clinical features and laboratory parameters in children suspected to have TB and to find out the most useful parameter to diagnose TB in children. Materials and Methods: This was a retrospective cross-sectional study conducted in a rural medical college hospital during the year 2017. Children up to the age of 14 years with a clinical diagnosis of suspicious TB were included in the study and the confirmation of TB was evaluated. All demographic data, contact history, symptoms, clinical findings, and laboratory parameters were retrieved from the medical records department and analyzed. Results: A total of 102 children were included in the present study and the predominant age group affected was between 5 and 10 years (30.4%) with male predominance (55%). The predominant clinical presentation was cervical lymphadenopathy (n=46; 45%) followed by contact history of contact with TB (n=34; 33.3%). Among the investigations, Mantoux positivity was observed in six cases, granulomatous lymphadenitis in 10 cases, and one pleural fluid analysis showed evidence of TB. Of 102 cases, 14 cases were confirmed as TB and one as latent TB infection (LTBI). Among the confirmed cases, cytological study was useful for confirming TB in 71.4% of cases, Mantoux positivity for five cases of TB (35.7%), and one case of LTBI. Conclusion: Cervical adenitis and contact history were common among suspected TB children and lymph node cytological study followed by Mantoux test was the useful parameters for confirming TB. Kalyanaraman and Sumathi Clinicopathological profile of children evaluated for suspected TB
doi:10.32677/ijch.2019.v06.i07.009 fatcat:hnrvgknor5hyxjgzqafq6t4vla