DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20214533

Study of extrapulmonary tuberculosis in tertiary care hospital children with reference to cartridge based nucleic acid amplification test

Chirag Shah, Shantanu Jain, Pathik Patel

Abstract


Background: Tuberculosis is an infectious disease cause by the mycobacterium tuberculosis which typically involve lung but can affect other site called extrapulmonary tuberculosis (EPTB). In EPTB lymph node tuberculosis is most common and most severe is tuberculous meningitis. Cartridge based nucleic acid amplification test (CBNAAT) have high sensitivity and perform both respiratory and non-respiratory specimen. The aim of this retrospective study is to find out the proportion of extra pulmonary tuberculosis in hospitalized patient and determine the association of CBNAAT in diagnosis EPTB and Rifampicin resistance.

Methods: This is the retrospective observational study done at Civil Hospital Ahmedabad in between October 2017 to October 2019 among the admitted patient age 1 month to 12 year diagnosed cases of EPTB according to RNTCP guidelines. Data collection done by medical records as indoor case sheets and investigation data from laboratory department.

Results: Incidence of EPTB among the hospitalized children is 1.95% and among total tuberculosis patient is 42.48%. Among 191 suspected EPTB cases 59 confirmed indicate sensitivity of 37.3% and no false positive cases indicate 100% positive predictive value. Sensitivity of CBNAAT was highest in gastric aspirate followed by CSF in present study.

Conclusions: Tuberculosis is more common in male child less than 5-year-old with frequent risk factor is rural residential area, lower socioeconomic class and contact with active cases. In my study is CNS tuberculosis is most common. In my study mortality is higher among 1-to-5-year age group with co morbid condition are SAM and septicemia.


Keywords


EPTB, CBNAAT, RNTCP, TB lymphadenitis, CNS tuberculosis

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References


WHO global tuberculosis report. 2018. Available at: https://apps.who.int/iris/handle/10665/274453. Last accessed at 04 July 2021.

Central TB Division. Tuberculosis India 2019. Annual report of the Revision National Tuberculosis Control Programme, Directorate of general health services. Ministry of Health and Family Welfare, gov of India 2012. https://tbcindia.gov.in/ index1.php?page=1&ipp=AllāŒ©=1&level=1&sublinkid=4160&lid=2807. Last accessed at 04 July 2021.

Draft updated IAP RNTCP Ped Tuberculosis Guideline 2019. Available at: http://tbcindia.gov.in. Accessed on 19 July 2021.

Director general health services. Department of tuberculosis (NTP) DGHS, MOHFW, New Delhi.

Virani T, Shukla S. Clinico radiological profile and operalisation of childhood tuberculosis dissertation, Vadodara. 2008. https://apps.who.int/iris/bitstream/ handle/10665/112472/9789241506335_eng.pdf;jsessionid=7AB23A85B2B65B79B6705D6ECFF47A08?sequence=1. Last accessed at 04 July 2021.

Israni A. Tuberculus meningitis in children (Tubercular meningitis in children: clinical, pathological and radiological profile and factors associated with mortality). Journal Of Neuroscience In Rural Practice. Available at: https://www.researchgate.net/publication/301740369_Tubercular_meningitis_in_children_Clinical_pathological_and_radiological_profile_and_factors_associated_with_mortality. Last accessed at 04 July 2021.

Chadha VK, Jagannatha PS. Average annual risk of tuberculosis infection in india Int. J Tuberc Lung. Dis. 2005,9:116-8.

Sheth V, Kabra SK. Essential of tuberculosis in children, 3rd edition. 150-1.

Tortoli EC, Russo. Clinical validation of Xpert MTB /RIF for diagnosis of extra pulmonary tuberculosis. Int J Inf Dis. 2020;95:15-21.

Avishia S, Bansal D, Agrawal AK. Comparision of conventional methods with Gene XpertMTB/RIF for Rapid detection of mycobacterium tuberculosis and rifampicin resistance in extra pulmonary sample. Int j Med Res. 2016:4(2):181-5.

Hillemann D. Rapid detection of mycobacterium tuberculosis and rifampicin resistance in extra pulmonary sample using Gene Expert MTB/RIF. Syteme J Clin Microbial. 2011;49(4):1202-5.

Ahmad NS, Khan S. Rapid detection of mycobacterium tuberculosis and rifampicin resistance in extra pulmonary samples using Gene XpertMTB/RIF. ISOR Journal of Dental and Medical science. 2014;13(11):2279-861.