Symptomatic and Asymptomatic Tuberculosis in Children from Family Contacts

Abstract

RATIONALE Tuberculosis (TB) is a global health problem. Globally, in 2019, 9.96 million people fell ill with TB, including 1.19 million children aged 0-14 years. Children from family contacts have the highest risk of TB. Testing for TB and COVID-19 for individual indications in children can be done simultaneously. This will provide significant benefits for the detection of two infectious diseases. The study of TB with pulmonary symptoms and TB without symptoms (asymptomatic) will be essential for rational screening. Objective: The study of 333 cases of symptomatic and asymptomatic pulmonary TB in children from family contacts of bacteriologically confirmed pulmonary TB cases. METHODS The focus group included 74 children with symptomatic pulmonary TB and 259 children with asymptomatic pulmonary TB from family contacts. Analysis of history of disease, comorbidity, clinical, bacteriological, X-ray methods and statistical analysis (Student's t-test, χ2-test) have been applied.RESULTSBoth groups did not differ by quantity of boys and girls. The group of children with symptomatic TB included 29 boys (39,2%) and 45 girls (60,8%). The group of children with asymptomatic TB included 128 boys (49,4%) and 131 girls (50,6%). Differences between groups is not valid (χ2=2,418;p=0,120). The average age of the children with symptomatic TB was 14,5 ± 3,8 years, in children with asymptomatic TB - 13,8 ± 4,7 years. Differences between groups is not valid ( p>0,05).The frequency of excretion of Mycobacterium tuberculosis in the groups differed. The excretion of Mycobacterium tuberculosis was determined in 36 children (48,6%) with symptomatic TB and 57 children (22,0%) with asymptomatic TB (χ2 = 20,295;p<0,001).The frequency of lung cavities in the groups differed. Cavities were recorded in 24 children (32,4%) with symptomatic TB and 39 children (15,1%) with asymptomatic TB (χ2 = 11,327;p<0,001). Drug resistance was observed in 7 children (9,5%) with symptomatic TB and 14 children (5,4%) with asymptomatic TB (χ2 = 1,601;p = 0,206). The difference is not significant. Comorbid diseases have been reported in 53 children (71,6%) with symptomatic TB and 188 children (72,6%) with asymptomatic TB (χ2 = 0,027;p = 0,870). The difference is not significant.CONCLUSIONSChildren with symptomatic TB from family contacts often had a more severe form of TB. They more often the excretion of Mycobacterium tuberculosis and lung cavities compared to children with asymptomatic TB. The absence of pulmonary symptoms in children from family contacts does not exclude the presence of TB.