Clinical profile and outcome of children with tuberculosis in a tertiary care hospital in Mumbai, India

Abstract

Introduction: As children are usually infected by an adult with pulmonary tuberculosis (TB), childhood TB reflects transmission of Mycobacterium tuberculosis within a community Objective: To study clinical profile and outcome of children with TB from 0 to 12 years of age in a tertiary care hospital in Mumbai, India. Method: A prospective observational descriptive study of 30 children with TB was conducted over 18 months at a tertiary general hospital in Mumbai and followed up till recovery. Results: Out of the 30 children with TB, 3 (10%) were below the age of 1 year, 8 (26.6%) were aged 1-5 years and 19 (63.3%) were above 5 years of age. Male to female ratio was 1:1.3. Extrapulmonary TB was more common (63.3%) than pulmonary TB (36.6%). Twenty (66.6%) children had a history of previous adult contact with TB, 29 (96.6%) were vaccinated with BCG and 10 (33.3%) were malnourished. Common clinical features were cough (53.3%), fever (46.6%), weight loss (46.6%) and lymphadenopathy (33.3%). Anaemia and raised ESR were seen in 46.6% and 73.3% respectively. All 30 children were non-reactive for the HIV antibody test. Tuberculin sensitivity test was positive in 16 out of 30 children (53.3%). Drug-resistant TB was seen in 2 (6.6%) children. All 30 cases (100%) recovered completely with their primary regimen. Conclusions: In this study, extra-pulmonary TB was found in 63.3% of children. TST positivity (>10mm) was found in only 53.3% of children with TB. Complete resolution of symptoms was seen in all cases except the case of the Potts spine patient who had a residual spine deformity after completing treatment. A weight gain of ≥10 % of body weight at diagnosis was seen at the end of 3 months in the age groups <1 year and >5-12 years.