Pediatric Tuberculosis at Beijing Children's Hospital: 2002-2010

Capital Medical University, Peping, Beijing, China
PEDIATRICS (Impact Factor: 5.47). 11/2012; 130(6). DOI: 10.1542/peds.2011-3742
Source: PubMed


Our aim was to describe the patient characteristics, clinical-epidemiological profile, and treatment outcome of childhood tuberculosis (TB).

A retrospective, descriptive study was undertaken of 1212 children aged 0 to 18 years admitted to Beijing Children's Hospital for the treatment of TB from January 2002 to December 2010. Statistical significance of category variables was evaluated by using Fisher's exact test.

Fifty-four percent of patients had extrapulmonary tuberculosis (EPTB), 38.8% had tuberculous meningitis, and 31.3% had disseminated TB. The last 2 types were defined as severe TB. Most patients with TB (81.6%) were cured or completed treatment. There were more patients aged <5 years and from rural areas with EPTB than with pulmonary tuberculosis. More severe cases of TB were found in patients aged <1 year than other less severe types of TB. Patients with no bacille Calmette-Guérin vaccination and a contact history at home had a significantly risk of contracting severe TB. Children aged <1 year and those with severe TB were more likely to have poor treatment outcomes (failed to improve or died). Among those with EPTB, only 61.3% and 61.1% had positive results on the purified protein derivative tuberculin skin test and chest radiograph, respectively.

In this referral hospital setting, more pediatric EPTB and severe TB patients were found among children aged <1 year. Age <1 year and having severe TB were risk factors for treatment failure. Thus, prevention and health care in pediatric TB should focus on both EPTB and severe TB.

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    • "Generally in developing countries, the low 10%–15% positive rate of the AFB microscopy in pediatric TB cases is accompanied by very low sensitivity of the MTB culture, since 20% to 80% of children who suffered from TB do not have positive MTB culture results [21]. And a retrospective study of pediatric TB cases in hospital also found the positive rate of AFB microscopy or MTB culture (either one was positive) was only 9.7% [22]. That suggests just using AFB microscopy and MTB culture to confirm childhood PTB is not nearly enough. "
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