Clinical profile of children with tuberculosis from a semi urban referral centre in South India: a prospective observational study

Abstract

Background: Global TB report 2018 reports that in India, an estimated 2.2 lakh children become ill with tuberculosis (TB) each year. In spite of new rapid diagnostic methods, lack of gold standard test for confirming childhood tuberculosis remains an obstacle for the effective reporting of childhood TB and hence these cases often remain under diagnosed. The main objective was to study the clinical profile of childhood tuberculosis with relevant laboratory investigations aiding in early diagnosis.

Methods: A prospective observational hospital-based study was conducted in IRT-Perundurai medical college hospital from April 2016 to March 2018. Children less than 18 years of age with tuberculosis were included in the study. Demographic details, presenting symptoms, family history of TB contact, nutritional status and clinical examination findings were documented. Complete blood count, ESR, Mantoux test, chest X-ray and sputum analyses for AFB were done for all patients.

Results: Out of the total 124 children studied, the most common age of presentation of tuberculosis was >10 years of age (n=58, (46.8%)). There was a female preponderance (n=71 (57.25%)). Pulmonary tuberculosis (n= 87, (70.16%)) was the most common form followed by extra pulmonary (n=32, (25.80%)) and disseminated type (n=5, (4%)).  Lymph node TB was the most common manifestation (n=20, 62.50%) among extra pulmonary form. Cough (n=75, 60.5%) with sputum (n=55,44.4%) were the predominant symptoms noted followed by fever (n=53, 42.7%). Bacteriological diagnosis was possible in 19.5% (n=17) patients only.

Conclusions: This study reinforces that the diagnosis of childhood tuberculosis is based on the constellation of symptom evaluation, contact history, clinical examination, with relevant laboratory investigations.