Screening of tuberculosis in hospitalized severely acute malnourished children in a tertiary care hospital

Kinjal G. Patel; Chintan B. Pandya; Sujeet S. Chaudhari

doi:10.18203/2349-3291.ijcp20252956

Authors

Kinjal G. Patel Department of Paediatrics, GMERS Medical College, Valsad, Gujarat, India
Chintan B. Pandya Department of Paediatrics, GMERS Medical College, Valsad, Gujarat, India
Sujeet S. Chaudhari Department of Paediatrics, Government Medical College, Surat, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20252956

Keywords:

Tuberculosis, Malnutrition, CBNAAT, Children

Abstract

Background: Tuberculosis (TB) remains one of the leading causes of infectious disease-related morbidity and mortality worldwide. There is an increase susceptibility to TB due to impaired immunity in malnourished children.

Methods: This is a cross-sectional study done at a tertiary care hospital over a period of 1 year. Children aged 6 months to 5 years diagnosed with severe acute malnutrition (SAM) based on World Health Organization (WHO) criteria were enrolled in the study. Screening for tuberculosis was performed using: Monteux test, chest X-ray, sputum or gastric aspirate microscopy or cartridge-based nucleic acid amplification test (CBNAAT) for Mycobacterium tuberculosis detection.

Results: A total of 165 SAM patients were screened for TB. Prevalence of TB in SAM patient was 3.63%. Among the 6 cases, 4 were extra pulmonary and 2 were pulmonary TB. The most frequent symptoms were cough (34.56%), vomiting (26.66%), and diarrhoea (25.45%). Fever was seen in 24.24%, and weight loss in 14.54%. The Monteux test results was negative in all patients. CBNAAT testing was positive in only 2 patient (1.21%). Out of 165 children, 2.42% had elevated erythrocyte sedimentation rate (ESR) and 14.55% had an abnormal chest X-ray. Mesenteric lymphadenitis was observed in 9 patients (5.45%) in abdominal ultrasonography.

Conclusions: This study highlights that clinical features of tuberculosis were nonspecific. Diagnostic limitations were evident as the Monteux test yielded 0% positivity, and CBNAAT only in 1.21%. This study emphasizes the need for high clinical suspicion in paediatric TB, particularly in malnourished children.

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