Evaluation of the clinico-radiological profile and its therapeutic implications in childhood tuberculosis: a prospective study

Abstract

Aim: to evaluate the clinico-radiological profile in childhood tuberculosis related to its diagnostic, prognostic and therapeutic implications at tertiary health care centre. Material and methods: This was a prospective study was done in the Department of Paediatric, Vardhman Institute of Medical Science (VIMS) Pawapuri, Nalanda, Bihar, India for 14 months. Total 100 children’s with age up to 5yrs and  suspected diagnosis of tuberculosis were included in this study. For every child who was included in this study a detailed clinical history to assess demographic data such as age sex, residence, parental occupation, parental education, family size, birth order, socio-economic status which determines disease status was recorded in detail. Especial emphasis was given to check for BCG scar mark. Laboratory investigations were done for all the children. Results: Out of 100 cases 32 patients (32%) were in 4-5 year of age group followed by 30(30%) in 2-3 yeas age group, 18(18%) in 1-2 yrs, 16 (16) in 3-4 yrs and only 4 (4%) belong to 0-1 year age group. Male to female ratio was 1.8:1 with 65% male and 35% female. CNS tuberculosis is commonest type (67%), followed by intra-thoracic (18%), disseminated (8) and abdominal (6%). Only one case of lymph node tuberculosis. Most of the patients (60%) have grade III and grade IV malnutrition. Majority of malnourished patients belong to 2-3 years and 4-5 years of age group. 52% patients also having history of contact with Tuberculosis and 24% have h/o Measles. lymph node TB and disseminated TB, h/o contact is positive in 100% cases, where in CNS TB only 50.75% patients having h/o contact. Total only 52% patients, having positive contact history. There is another important interference from this table that in 50% children BCG scar was not present. Conclusion: childhood tuberculosis remained the neglected part in NTCP until RNTCP was introduced. Childhood cases have shown increasing trends with the advent of HIV infection. Prompt suspicion and early diagnosis can be an important step in controlling this epidemic.

Keywords: clinical profile, childhood tuberculosis , Neurotuberculosis, Disseminated Koch’s