Treatment delay in childhood pleural tuberculosis and associated factors

Abstract

Background Delay in diagnosis and treatment worsens the disease and clinical outcomes, which further enhances the transmission of tuberculosis (TB) in the community. Therefore, this study aims to assess treatment delay and its associated factors among childhood pleural TB patients in China. Methods Between January 2006 and December 2019, consecutive patients aged ≤15 years with definite or possible pleural TB were included for analysis. Treatment delay duration was defined as the time interval from the onset of symptoms to treatment initiation and was stratified into two categories: < 30 days, ≥30 days (median delay day is 30 days). The electronic medical records of children were reviewed to obtain demographic characteristics, clinical characteristics, laboratory examinations, and radiographic findings. Univariate and multivariate logistic regressions were used to explore the factors associated with treatment delay in patients. Results A total of 154 children with pleural TB were included, with a mean age of 12.4 ± 3.3 years. The median treatment delay was 30 days (interquartile range, 10–60 days) and 51.3% (n = 79) of patients underwent a treatment delay. Multivariate analysis revealed that heart rate (≤92 beats/min, age-adjusted OR = 2.503, 95% CI: 1.215, 5.155) and coefficient of variation of red cell distribution width (RDW-CV, ≥12.9%, age-adjusted OR = 4.705, 95% CI: 2.048, 10.811) were significant risk factors for treatment delays in childhood pleural TB. Conclusion Our findings suggested that a significant treatment delay occurs among children with pleural TB in China. Patients with a low heart rate or a high RDW-CV experienced delays in the initiation of anti-TB therapy. Therefore, well awareness of the associations between clinical characteristics and treatment delay may improve the management of children with pleural TB and enable us to develop preventive strategies to reduce the treatment delay.

Epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China during 2017–2022

“…The main reasons may be as follows: First, some schools did not seriously implement physical examinations and routine physical for freshmen. Second, students' academic pressure, bad living habits, mild symptoms, and late medical treatment led to cluster onset ( 17 , 18 ).…”

Factores de riesgo en el retraso de tratamiento de tuberculosis infantil en un hospital peruano

“…Estas diferencias pueden explicarse debido a la heterogeneidad en la conceptualización de la variable retraso del inicio del tratamiento y desde que momento se considera este presente. Cabe resaltar que el retraso en el tratamiento, sobre todo en TBI constituye una amenaza latente a nivel global con respecto al desarrollo de esta enfermedad 18,19 .…”

“…En el paciente con TBI las características clínicas y radiológicas son menos específicas respecto al adulto, sin embargo, la sospecha epidemiológica, la prueba de tuberculina (Mantoux) y la radiografía de tórax siguen siendo importantes para su diagnóstico 2, 19 .…”

“…En esta investigación con respecto a las características clínicas que presentaron los pacientes se determinó que la sintomatología clínica, radiografía de tórax y la baciloscopia no tuvieron una asociación estadísticamente significativa con respecto al inicio tardío del tratamiento en la TBI (p = 0,176), (p = 0,812) y (p = 0,707) respectivamente. Estos resultados difieren de un estudio en donde se encontró una asociación entre las manifestaciones clínicas y la demora en el tratamiento ya que se puede disminuir este tiempo tomando en cuenta la aparición de esta sintomatología en los pacientes, el uso de la imagenología también está relacionado con la disminución del tiempo en el que se tarda en brindar el tratamiento en la TBI según un estudio realizado en Bangladesh 19,23 .…”

Direct medical cost and cost analysis of COVID-19 in Iran

“…The authors followed the applicable EQUATOR Network ( http://www.equator-network.org/ ) guidelines, during the conduct of this research project. [ 38 39 ]…”