HOUSEHOLD TB CASE FINDING RESULTS AND CLINICAL IMPROVEMENT OF CHILDREN WITH ENDOBRONCHIAL TUBERCULOSIS

Abstract

Background/Purpose: Children previously treated for tuberculosis (TB) but with missed household TB case finding are diagnosed with endobronchial TB (EBTB) thru flexible bronchoscopy in our clinic. We aim to describe our clinical experience with TB case finding in households of children with EBTB and report the relationship of case finding results and the clinical improvement of these children. Methods: This cross-sectional study performed TB case finding in households of 26 children (index cases) within 7 days of index case diagnosis and treatment. Clinical improvement of an index case, radiologic finding of disease regression and TB smear conversion after EBTB treatment served as basis for case improvement. Results: 168 household contacts at 1:6 average index case to household contact ratio was seen among 26 children (ages 5-17 years) with EBTB. Seventeen (10.11%) M. tb smear positive adult source cases were identified. Only 112 (66.67%) household contacts completed TB screening within prescribed time while 39 (23.21%) were delayed. Financial constraints, employment types and personal disapproval of individual were the main reason for delay in TB case finding among uncompliant household contacts. Fourteen index cases (53.85%) had clinical improvement at 2 months and 10 (38.4%) children improved after 2-6 months of EBTB treatment. Two (7.69%) with severe fibrostenotic types of EBTB did not improve after 6-12 months of EBTB treatment. A 100% clinical improvement seen for index cases with household TB case finding was completed within prescribed time while 81.81% was seen for those with delayed TB household case finding. Conclusions: TB case finding in the household of children diagnosed with tuberculosis promote successful disease containment and treatment outcome. There is still a need to emphasize TB case finding in the household of children diagnosed with tuberculosis to prevent severe complications of the disease.