Study of clinical profile and risk factors of childhood tuberculosis in patients attending tertiary care hospital in western rajasthan

Bhimwal R. K., Mohan Makwana., Prabhu Narayan Bairwa and Kanwar Lal

Background: Tuberculosis is of great public health concern especially in the developing countries. It is expected that approximately one third of the World's population is infected with Mycobacterium tuberculosis. The majority of cases belong to developing countries of Asia. Moreover, its clinical profile is different in developing countries in comparison to developed countries.
Methods: This study was conducted in the Department of Paediatrics, Dr S. N. Medical College, Jodhpur. Patients attending the outpatient department or admitted in the wards with symptoms and signs suggestive of tuberculosis were studied.
Study Design: Cross sectional study.
Sample size: 120 patients.
Inclusion criteria: Children from 6 months to 12 years of age who fulfilled the diagnostic criteria of Crofton et al (1992) for clinical tuberculosis.
Results: In study group maximum (44.16%) cases were in <3 years age group, The M: F ratio was 1.4: I., 67(55.83%) children belonged to joint family, 65.83% were Hindus. Most of the cases belonged to lower socioeconomic classes (Class IV and V; 63%). Most common presenting symptoms were fever (78.4 %,) cough (64.1%) with past history of measles and whooping cough was present in 18.33% and 10% cases respectively.43.33% cases were having history of contact with tuberculous patients within household or in near relatives and neighbours. Most of the cases were moderate to severely (grade III and IV) malnourished. Pulmonary tuberculosis was more common in grade II, III and IV malnourished. Only 27% cases of tuberculosis had received BCG vaccination and 73% cases were unimmunized. MT was positive in 20.8% of cases and direct BCG test was positive in 52.5% of cases. Most common radiological finding was hilar prominences followed by bronchopneumonia. Most common type of presentation was primary complex followed by Progressive primary disease (PPD), TBM, tubercular lymphadenopathy, abdominal tuberculosis. On fundus examination, papilledema and in CT scan, hydrocephalous was most common finding in TBM cases
Conclusions: There is an urgent need for a systematic approach for determining the prevalence and incidence of M. tuberculosis infection among children. This has to become the corner stone of TB control and of assessing the change in trend of infection over time, in the community; until it reaches the required goal, as defined for control status by WHO.

Download PDF: