Clinico-epidemiological profile and diagnostic procedures of tuberculosis in children: a study from OPD of Bangabandhu Sheikh Mujib Medical University

Mujammel Haque; M. Asif Ali; Taslima Ferdosh; Manik Kumar Talukder

doi:10.18203/2349-3291.ijcp20251463

Authors

Mujammel Haque Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
M. Asif Ali Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
Taslima Ferdosh Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
Manik Kumar Talukder Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20251463

Keywords:

Tuberculosis, Pulmonary, Extrapulmonary tuberculosis, Mantoux test, Gene Xpert

Abstract

Background: Childhood tuberculosis (TB) is a significant cause of mortality and morbidity, contributing to a considerable TB burden in developing countries like Bangladesh. The aim of this study was to describe the clinical profile and diagnostic procedures in childhood TB cases in the outpatient department (OPD) of a tertiary care hospital.

Methods: This cross-sectional study was conducted on children aged 3 months to 18 years from July 2023 to June 2024 in the OPD of the Paediatrics Department at Bangabandhu Sheikh Mujib Medical University (BSMMU) who were diagnosed with tuberculosis according to the National Guidelines for the Management of Tuberculosis in Children, 2021. Data were collected through direct interviews and analyzed by MS Excel.

Results: Among 834 suspected patients, 139 were diagnosed with tuberculosis. Here, 47.48% cases were pulmonary TB and 52.51% were extrapulmonary TB (EPTB). Among EPTB 30.93% were TB lymphadenitis. Common symptoms like fever were present in 84.48%, weight loss in 69.78%, cough in 64.74% and lumps in the neck and axilla in 35.25% cases. Mantoux test was positive in 71.92%, abnormal chest X-ray findings in 46.76%. Fine needle aspiration cytology from lymph nodes was suggestive in 32.37%. Sputum GeneXpert and stool GeneXpert ultra tests were positive in 10.79% and 20.14% respectively.

Conclusion: This study found that cases of extrapulmonary TB were more prevalent than pulmonary TB among children. The diagnosis of tuberculosis was primarily based on clinical suspicion, supported by various investigations, especially bacteriological detection through stool and sputum GeneXpert ultra tests in children.

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References

WHO. Global Tuberculosis Report. 2022. Available at: https://cdn.who.int/media. Accessed on 22 December 2025

National Tuberculosis Control Program, Tuberculosis Control Program in Bangladesh, Annual Report, Directorate General of Health Services, Dhaka, Bangladesh. 2020.

WHO Report: WHO report Global tuberculosis control surveillance, planning, financing. 2003. Avaialble at: http://www.who.int/tb. Accessed on 21 November 2024.

Dolin PJ, Raviglione MC, Kochi A. Global tuberculosis incidence and mortality during 1990-2000. Bull World Health Organ. 1994;72:213-20.

Nelson LJ, Wells CD. Global epidemiology of childhood tuberculosis. Int J Tuberc Lung Dis. 2004;8(5):636-47.

Donald PR. Childhood tuberculosis: out of control. Curr Opin Pulm Med. 2002;8:178-82. DOI: https://doi.org/10.1097/00063198-200205000-00005

Lin YS, Huang YC, Chang LY, Lin TY, Wong KS. Clinical characteristics of tuberculosis in children in the north of Taiwan. J Microbiol Immunol Infect. 2005;38:41-6.

Wong KS, Chiu CH, Huang YC, Lin TY. Childhood and adolescent tuberculosis in northern Taiwan: an institutional experience during 1994-1999. Acta Paediatr. 2001;90:943-7. DOI: https://doi.org/10.1111/j.1651-2227.2001.tb02462.x

Nelson LJ, Schneider E, Wells CD, Moore M. Epidemiology of childhood tuberculosis in the United States, 1993-2001: the need for continued vigilance. Pediatrics. 2004;114:333-41. DOI: https://doi.org/10.1542/peds.114.2.333

Uysal G, Gursoy T, Guven A, Gunindi F, Cuhaci B. Clinical features of extrapulmonary tuberculosis in children. Saudi Med J. 2005;26:750-3.

Udani PM. BCG test in the diagnosis of tuberculosis in children. Indian Pediatr. 1982;19:563-81.

World Health Organization. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children: policy update. Geneva, Switzerland: WHO. 2013.

Franco R, Santana M. Clinical and radiological analysis of children and adolescents with tuberculosis in Bahia, Brazil. Brazilian J Infect Dis. 2003;7:73-81. DOI: https://doi.org/10.1590/S1413-86702003000100009

Shrestha S, Bichha RP, Sharma A, Upadhyay S, Rijal P. Clinical profile of tuberculosis in children. Nepal Med Coll J. 2011;13:119-22.

Sancjez-Albisua I, Vidal LML, del Castillo MF, Borque C, Garcia-Miguel MJ, Garcia- Hortelano J. Pulmonary tuberculosis in children: its agedependent aspects. Esp Pediatr. 1998;48:251-5.

Ahsan MR, Hussain M, Makbul S, Sarkar PK, Al Mamun AM. Clinical Pattern of Pediatric Tuberculosis in a Tertiary Care Hospital in Bangladesh. Dhaka Shishu (Children) Hospital J. 2019;35(1):9-13. DOI: https://doi.org/10.3329/dshj.v35i1.51702

Swaminathan S, Datta M, Radhamani MP, Mathew S, Reetha AM. A profile of bacteriologically confirmed pulmonary tuberculosis in children. Indian Pediatr. 2008;45:743-7.

Ullah S, Shah SH, Rehman AU, Kamal A, Begum N. Tuberculous lymphadenitis in afghan refugees. J Ayub Med Coll Abbottabad. 2002;14:22-3.

Dendup T, Dorji T, Edginton ME, Kumar AVM, Wangchuk D, Dophu U, et al. Childhood tuberculosis in Bhutan: profile and treatment outcomes. Public Health Action. 2013;3:11-4. DOI: https://doi.org/10.5588/pha.12.0091

Bajaj M, Sood AK, Mahajan S, Garg A. Clinical profile of tuberculosis in children: a prospective study from tertiary care Institute in sub Himalayan region. J Med Sci Clin Res. 2008;2:699-705.

Phongsamart W, Kitai I, Gardam M, Wang J, Khan K. A population-based study of tuberculosis in children and adolescents in Ontario. Pediatr Infect Dis J. 2009;28(5):416–9. DOI: https://doi.org/10.1097/INF.0b013e3181920d4d

Maltezou HC, Spyridis P, Kafetzis DA. Extrapulmonary tuberculosis in children. Arch Dis Child. 2000;83:342–6. DOI: https://doi.org/10.1136/adc.83.4.342

Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis. 2009;49:1350–7. DOI: https://doi.org/10.1086/605559

Sreeramareddy CT, Panduru KV, Verma SC, Joshi HS, Bates MN. Comparison of pulmonary and extrapulmonary tuberculosis in Nepal-a hospital-based retrospective study. BMC Infect Dis. 2008;2:8. DOI: https://doi.org/10.1186/1471-2334-8-8

Garg P. Childhood tuberculosis in a community hospital from a region of high environmental exposure in north India. J Clin Diag Res. 2008;2:634-38.

Hatwal D, Chaudhari S, Joshi AK, Rathaur VK. Patterns of extrapulmonary tuberculosis in children: a hospital-based study. Indian J Comm Health. 2013;25:22-27.

Pama CP, Gatchalian SR. Clinical profile of culture proven tuberculosis cases among Filipino children aged 3 months to 18 years. PIDSP 2002;5:13-23.

Kabir S, Rahman SMM, Ahmed S, Islam MS, Banu RS, Shewade HD, et al. Xpert Ultra Assay on Stool to Diagnose Pulmonary Tuberculosis in Children. Clin Infect Dis. 2021;73(2):226-34. DOI: https://doi.org/10.1093/cid/ciaa583