Description of Pediatric Tuberculosis Evaluated in a Referral Center in Istanbul Turkey

Abstract

PurposeDiagnosis of tuberculosis (TB) in children is more challenging than in adults. This study aimed to describe demographical, clinical and laboratory findings of children diagnosed with tuberculosis in Turkey, including the issues of contact tracing, culture positivity and forms of the disease.Materials and MethodsClinical and laboratory data of 51 children with a mean age of 8.0±4.6 years who were diagnosed with TB were retrospectively reviewed. Main diagnostic tools included tuberculin skin test, chest X-ray, sputum/gastric aspirate culture with sensitivity testing, and direct microscopy for acid-fast bacilli on available samples. Clinical characteristics and outcomes of the patients were examined.ResultsThirty-six (70.6%) children were diagnosed with intra-thoracic and 15 (29.4%) with extra-thoracic tuberculosis. Twenty-eight of the patients had a positive Bacillus Calmette-Guérin vaccine scar (28/51, 54.9%) and 23/51 (45.1%) had a positive tuberculin skin test. An adult TB contact was identified in 27 (52.9%) of the cases. On direct microscopy, acid-fast bacilli were found in nine (17.6%) patients and positive culture for Mycobacterium tuberculosis was found in 19 (37.3%). Drug resistance to isoniazid was detected in four (7.8%). One patient with nephrotic syndrome and miliary tuberculosis died during follow-up. All other patients responded well to the treatment.ConclusionFocusing on active contact tracing among all household contacts of tuberculous cases may be helpful in early identification and controlling childhood disease, even in regions with low disease prevalence. Adopting a suspicious and proactive approach in this particular age group is warranted.

Clinical Manifestations and Diagnosis of Extrapulmonary Tuberculosis in Children

“…As the fourth drug, streptomycin was preferred in 78.1% of the cases and ethambutol in 21.8% of the cases. Similar to our study, Guleç et al have preferred streptomycin in 79% of the cases and ethambutol in 21% as the fourth drug (30). No drug side effect was seen in our patients apart from temporary liver enzyme elevation and uric acid elevation, and visual fields and auditory tests were found normal during follow-up.…”

Diagnosis of pediatric pulmonary tuberculosis with special reference to polymerase chain reaction based nucleic acid amplification test

“…In those 71 children who received ATT, the sensitivity of PCR, culture and microscopy was 47.8%, 43.6% and 18.3%, respectively. Higher sensitivities have been reported in literature [20][21][22]. However, these have compared the performance of PCR against culture.…”

Understanding pediatric tuberculosis: Perspectives and experiences of the parents in a city of India

“…[1] TB has been still a global health problem, particularly in high-burden areas, namely, Africa, South East Asia, Eastern Mediterranean regions, and Western Pacific, with respective incidences of 280, 183, 121, and 87 cases per 100,000 population per year. [2,3] The contribution of children to the total TB caseload is poorly documented, especially in countries with a high from the human research Ethical Committee of Veer Narmad South Gujarat University, Surat.…”