Etiology and Outcome of Tuberculosis among Paediatric Patients in a Specialized Paediatric Hospital

Author(s): Md. Atiqul Islam*, Mohammed Jafor Iqbal, Tanusree Sen, Sonia Saif, Mizanur Rahman

Introduction: Tuberculosis (TB) remains a significant public health challenge, particularly in children, where its presentation can vary from pulmonary to extra-pulmonary forms. This study aims to explore the clinical spectrum of TB in children, including the distribution of types, diagnostic methods, and treatment outcomes.

Methods: This cross-sectional study was conducted at the Department of Paediatric Infectious Diseases and Community Paediatrics in Bangladesh Shishu (Children) Hospital and Institute during the period from January 2022 to January 2023. A total of 100 Paediatric patients diagnosed with tuberculosis were selected as study subjects. Data were entered into Microsoft Excel and analysed using SPSS software. Descriptive statistics were used to summarize the findings, with frequencies and percentages reported for categorical data. Chi-square tests were applied to determine the association between variables like type of tuberculosis, diagnostic findings, treatment regimen, and outcomes. Statistical significance was set at a p-value <0.05.

Result: The study included 100 children with tuberculosis, showing a slight male predominance (60%). Pulmonary tuberculosis was the most common form (40%), followed by CNS tuberculosis (20%). Extra-pulmonary tuberculosis accounted for 60% of cases, with a variety of presentations including abdominal and lymphadenitis forms. The tuberculin skin test was positive in 64% of cases, with pulmonary TB having the highest positivity rate (75%). DOTS (intermittent therapy) was used in 52.1% of patients, while 47.8% received daily therapy. Overall, 5.6% of patients left against medical advice, and 4.2% expired. CNS tuberculosis had the highest mortality rate.

Conclusion: This study highlights the diverse clinical presentations and diagnostic challenges of tuberculosis in children, particularly the significant burden of extra-pulmonary TB. Pulmonary TB was the most common form, but extra-pulmonary TB accounted for the majority of cases, often with normal chest X-rays and low AFB positivity. The tuberculin skin test proved useful, but comprehensive diagnosis requires clinical, radiological, and molecular methods. Treatment outcomes were generally favorable, though CNS TB had higher mortality.