Sputum Negative Tubercular Adults Spread Infection and Disease to Their Household Children

Abstract

To examine whether tuberculosis sputum negative adults can spread disease to their household children. A patient based study was conducted over a time period of one year, on children of those adults who were suspected case of “sputum smear positive” as well as “sputum smear negative” diagnosed with pulmonary tuberculosis at JNMCH, India. Various investigations like tuberculin test, chest X-ray, fine needle aspiration cytology (FNAC) of lymph nodes, gastric aspirate, acid-fast bacilli (AFB) sputum smear examination and others were done to attain the goal of this study. Out of 129 children, 69 were in household contact of sputum smear positive and 60 in contact of sputum smear negative adults. Forty children were found to be Mantoux positive; of which the ratio of children that were in contact of sputum positive adult to those in contact of sputum negative adult was 2:1 (27 vs 13). A small percentage (6%) of asymptomatic children was found to be diseased. Sputum positivity, low socio-economic status as well as less than 3 years of age exhibited strong association with infection as well as disease; nonetheless the number of infected and diseased children in sputum smear negative group is not negligible. A considerable number of screened children that were in contact with sputum negative tubercular adult were found to be infected as well as diseased; hence this group should not be ignored. A portion of Mantoux positive children were found to be asymptomatic and one-third of diseased children were Mantoux negative, so Mantoux cannot be taken as a gold standard for diagnosis of tuberculosis.