Incidence Of Tuberculosis In Children Research Articles

Literature Study: Risk Factors for Tuberculosis in Children

Tuberculosis (TB) is one of the most deadly diseases in the world. Every day nearly 4,400 people lose their lives due to tuberculosis and nearly 300,000 people fall ill due to this disease. The aim of this research is to find out what factors influence the incidence of tuberculosis in children. The method used in this research is literature review. The results show that risk factors that influence the incidence of pulmonary tuberculosis in children include parental knowledge, nutritional status, BCG immunization status, history of contact with sufferers, exposure to cigarette smoke and residential density

Analisis Faktor Risiko TB paru Anak yang Tinggal Serumah dengan Penderita TB paru Dewasa

Pulmonary tuberculosis (TB) is still a major public health problem in Indonesia. Based on the Household Health Survey (SKRT) results tuberculosis is the number one respiratory disease and infectious disease. Tuberculosis in children causes growth disorders and even death. If pulmonary tuberculosis in a child is not treated immediately, it can quickly develop into parenchymal or tubercular pneumonia, milliary tuberculosis, bone tuberculosis (scrofuloderma), joint tuberculosis, abdominal tuberculosis, and even meningitis. This study used a case-control design with analytical observation. Children who were exposed to and lived in the same household with adult pulmonary tuberculosis patients as many as 90 adults participated in the study. The case sample consisted of children aged 0-15 years who were diagnosed with Pulmonary TB by doctors at the Wania Health Center, Mimika Regency. The case sample size was 30 respondents and the control sample was 30 respondents. The free variables in this study were parental knowledge, BCG vaccination history, child nutritional status, occupancy density, the behavior of TB sufferers at home, and length of contact. Data were analyzed using univariate analysis, bivariate analysis, and multivariate analysis (multiple logistic regression). The results of the study analysis showed that the factors that influence the incidence of tuberculosis in children are parental knowledge (p = 0.001), BCG vaccination history (p = 0.001), and the behavior of adult tuberculosis sufferers in the household (p = 0.000) The conclusion of the study was that the behavior of adult pulmonary tuberculosis patients who lived in the same house with children was most influential in the transmission of pulmonary tuberculosis in children who lived in the same household as adult pulmonary tuberculosis patients at the Health Centre of Wania, Mimika District.

Reactivation of Tuberculosis and COVID-19 in Pediatric Patients

Abstract Objective Mycobacterium tuberculosis is an immobile aerobic bacillus that causes tuberculosis (TB) disease. We aimed to evaluate the association between coronavirus disease 2019 (COVID-19), COVID-19-related drugs, TB reactivation, and TB incidence during the pandemic. Methods Eight patients who were diagnosed as having TB in Meram Medical Faculty, Necmettin Erbakan University between March 1, 2020, and December 31, 2021, at the beginning of the pandemic, were enrolled in this study. The presence of COVID-19 infection was confirmed using COVID-19 antibody tests and the patients' COVID-19 history. We evaluated the demographic data, laboratory findings, imaging tests, and pathology results of all patients. Results We checked all our patients with TB using COVID-19 antibodies (immunoglobulin [Ig]G + IgM) or polymerase chain reaction. Seven of the eight patients were female (87.5%). The median age was 16 years. Family screening of all patients was negative, and they had bacillus Calmette–Guérin vaccine scars. Two patients had chronic diseases. One was diagnosed as having primary ciliary dyskinesia in our department (patient no. 8) and the second was under follow-up by the rheumatology department with a diagnosis of juvenile idiopathic rheumatoid arthritis. Conclusion There has been an increase in the incidence of TB in children, especially in adolescents, during the pandemic period. This may be due to the pathogenic structure of the COVID-19 virus with an unknown mechanism. In addition, lifestyle changes and changes in health care policies during the pandemic may have caused this. Further research should be performed on this topic.

The Relationship between Family Smoking Habits and Tuberculosis Incidence in Children Aged 3-6 Years in Bandung Regency

Childhood tuberculosis in Indonesia is the third most common in the world, in 2020 the number of new child Tuberculosis cases decreased by 32.4%, this is still far from the government's target in 2024, which is 90%. Bandung Regency has 62 health centers, the highest number of child TB cases is at the Linggar Health Center, namely 42 children with Tuberculosis due to family factors that have smoking habits. The aim of the study was to determine the relationship between family smoking habits and the incidence of Tuberculosis in children aged 3–6 years in the Working Area of the Linggar Health Center. This type of research uses casecontrol with a population of 60 families with children aged 3-6 years. The sampling technique used purposive sampling, the sample is 60 families. Data collection using the Riskesdas 2018 questionnaire. Data analysis used univariate and bivariate analysis. The results of the study most of the cases (76.7%) were smokers while the controls (60%) were non-smokers. Family smoking status (P-value 0.004), type of white cigarette (P-value 0.002), number of cigarettes <12 cigarettes (P-value 0.006), duration of smoking > 19 minutes (P-value 0.000), and smoking in the house (P- value 0.001) has a relationship with TB in children. Of the five, smoking duration >19 minutes is the riskiest for TB in children (OR 19,286) because the longer the duration of family smoking, the more influential it is on the incidence of tuberculosis in children aged 3-6 years considering the content of smoking can reduce children's immunity. The conclusion of the study is that there is a relationship between family smoking habits and TB in children aged 3-6 years in the Working Area of the Linggar Health Center.

Tuberculosis prevalence in children in the Northwestern Federal District of Russia before and after COVID-19 pandemic: prognosis and epidemiological models

Aim. To assess changes in the epidemic indicators of tuberculosis infection (TB) in children in the Northwestern Federal District of Russia before and after the COVID-19 pandemic based on mathematical modeling and forecasting.Materials and methods. The main epidemiological indicators of TB were analyzed using the official statistical data for 2009–2021. A mathematical forecasting of epidemiological indicators was performed based on chest X-ray screening for TB. A statistical analysis was carried out using the software environment R (v.3.5.1) and the commercial software Statistical Package for Social Sciences (SPSS Statistics for Windows, version 24.0, IBM Corp., 2016). Time series forecasting was performed using the programming language of statistical calculations R, version 4.1.2 and the bsts package, version 0.9.8. Results. The mean regression coefficient of a single predictor was found to differ in a model for TB morbidity in children is 0.0098. X-ray screening for TB was established to be a significant mortality predictor in children. At least 60% of the population should undergo TB screening in order for TB prevalence to be controlled in a country with a population above 140 million people.Conclusions. The conducted study revealed a positive correlation between the incidence of tuberculosis in children in Russia and TB screening in at least 60% of the population. Under the current TB screening system in Russia, the epidemic TB situation will continue to improve, despite COVID-19 restrictions. At the same time, in the Northwestern Federal District of Russia, preventive TB screening can be considered sufficient only in the Kaliningrad, Murmansk, and Pskov Oblasts.

Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study

IntroductionAround the world, tuberculosis (TB) is the most common cause of mortality and morbidity in both adults and children. The incidence of tuberculosis (TB) is increased worldwide by co-infection with the human immunodeficiency virus (HIV), particularly in Sub-Saharan Africa. As a result, the study aimed to determine the incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia Comprehensive Specialized Hospitals. MethodsAn institution-based retrospective follow-up study was carried out in northeast Ethiopia’s Comprehensive Specialized Hospitals, among 362 children on antiretroviral therapy from January 1, 2007, to September 30, 2021. The data were entered into Epi Data version 4.6.1 and then exported to STATA version 16 for analysis. Bivariate and multivariable Cox proportional hazards model was used to discover tuberculosis predictors. Variables with a p-value of <0.05 at 95% confidence intervals in the multivariable Cox proportional hazard model were considered statistically significant. ResultsAmong the 358 Human Immunodeficiency Virus-infected children, two-thirds (69.3%) were over ten years old. The overall tuberculosis incidence rate was 2.0 (95%CI: 1.5–2.6) per 100 person-years with a total of 2452 years of observations. WHO clinical stages III and IV [AHR: 3.2 (95% CI 1.8–5.5)], being severely stunted [AHR = 2.1 (95% CI, 1.5–358)], and “Fair” and “poor” adherence levels to antiretroviral therapy [AHR = 4.0 (95% CI 1.5–10.8)] were independent predictors of tuberculosis. ConclusionThe incidence of tuberculosis in children infected with HIV/AIDS was high in this study. The risk of tuberculosis (TB) in HIV/AIDS-infected children has been linked to WHO stages III and IV, severe stunting, and "Fair" and "Poor" ART adherence. As a result, children with HIV/ADIS should be evaluated on a regular basis in order to improve the quality of ART services and reduce the incidence rate of tuberculosis among children.

MAPPING OF CHILDREN'S TUBERCULOSIS INCIDENCE BY COVERAGE OF BCG IMMUNIZATION, MALNUTRITION, AND HOME ENVIRONMENT

Background: Based on the Global Tuberculosis (TB) Report, Indonesia is one of the countries with a triple burden of TB, and TB disease can attack all age groups, including children. East Java Province in 2019 was ranked third in the highest number of pediatric TB cases in Indonesia. Purpose: This study aims to describe the distribution trend of tuberculosis cases in children in East Java Province in 2017-2018 based on BCG immunization coverage, cases of malnutrition, amount of healthy houses, and households with PHBS. Methods: The research design was a descriptive study with a correlation study design. The populations were all districts/cities in East Java Province, with as many as 38 districts. The data analysis technique to describe the trend distribution of tuberculosis in children was the health mapper software on a computer developed by World Health Organization (WHO). Results: The distribution of the incidence of tuberculosis in children in East Java from 2017 to 2018 tends to increase. The city of Surabaya became the area with the highest incidence of tuberculosis in children from 2017 to 2018. Based on a spatial map, most districts or cities with BCG immunization coverage, cases of malnutrition, several healthy homes, and high PHBS households experience tuberculosis incidence in children is high. Conclusion: Based on the map, spatially, districts or cities with high cases of tuberculosis in children mainly occur in areas with cases of malnutrition, the number of healthy home environments, and high coverage of BCG immunization as well.

Hubungan Imunisasi BCG dengan Tuberkulosis Paru pada Anak Balita di RSUD Dr.Moewardi

Background: Tuberculosis is still one of the main threats to public health as a cause of death from infectious diseases. One of the preventive efforts to prevent tuberculosis is the BCG immunization program, but the effectiveness of BCG immunization has decreased and the results differ in various research locations so it needs to be reviewed. This study aims to determine the relationship between BCG immunization and the incidence of pulmonary tuberculosis in children under five&#x0D; Methods: This research is an analytic observational design with a case control study conducted at RSUD Dr. Moewardi. Respondents in this study were divided into 2 groups, namely 30 case samples (pulmonary TB) and 30 control samples (non-pulmonary TB) where sampling was done by purposive sampling method. Samples were obtained from patient medical record data in the 2017-2019 period and then processed using SPSS 26 software&#x0D; Results: Based on the results of the bivariate analysis using the Fisher's Exact test, the correlation between phi (ρ) of 0.612 (α = 0.05) showed that there was no significant relationship between BCG immunization and pulmonary tuberculosis in children under five at Dr. Moewardi.&#x0D; Conclusion: There is no significant relationship between the provision of BCG immunization with the incidence of pulmonary tuberculosis in children under five at RSUD Dr. Moewardi Surakarta.

Tuberculosis situation among the pediatric population of Saratov Region (2015-2019)

Subjects and Methods. Incidence and prevalence of tuberculosis among children and adolescents in Saratov Region were retrospectively analyzed for 2015-2019.Results. The incidence of tuberculosis in children reflects general trends in the epidemic situation over the years in Saratov Region. In this region during 10 years of monitoring, tuberculosis incidence among children decreased 4 times by 2019 and it made 2.3 per 100,000 population, and among adolescents, it decreased 1.6 times (16.3 per 100,000 population). The number of children with post-tuberculosis changes detected for the first time increased 3 times in 2019 versus 2015, and the number of adolescents increased 4.5 times not only due to transition to tuberculosis screening in children aged 8-17 years old by skin test with tuberculosis recombinant allergen but also to the examination of children by computed tomography. The incidence in children followed up as Group IVA in 2019 was 15 times higher than this rate in the overall pediatric population. Analysis of the number of children and adolescents who developed tuberculosis and followed up as Groups IV and VI in 2015-2019 showed that the number of children ill with tuberculosis in Group IV was 3 times higher than the number of children in Group VI.

Prevalence and surveillance of tuberculosis in Yemen from 2006 to 2018.

Tuberculosis is a major public health issue in Yemen, a country located at the southwestern tip of the Arabian Peninsula, while the situation of tuberculosis had been further exacerbated since the war started in 2015. The objective of this study is to investigate the incidence of tuberculosis in Yemen before the outbreak of COVID-19, from 2006 to 2018. During the 13-year period, 92 482 patients were enrolled in the TB programme records from the 22 governorates. Almost equal number of cases were diagnosed between males and females (a male to female ratio, 1.03:1). A notable rising incidence was observed in all age groups starting from 2011. The sharpest increase occurred in children under age 15, rising by 8.0-fold from 0.5 in the period 2006-2010 to 4.1 in the period 2011-2018. Paediatric TB accounted for 9.6% of all reported cases. In terms of the patient residence, incidence has more than doubled in Sana'a city, Sana'a Gov., Hajjah and Saadah. Concomitant diseases with tuberculosis included diabetes mellitus (14.0%), brucellosis (6.1%), hepatitis (6.0%), rheumatoid arthritis (4.3%), renal disorders (2.5%) and HIV infection (2.5%). Development of interventions to reduce tuberculosis incidence in children and concomitant communicable diseases is urgently needed.

Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy.

Infection by the human immune deficiency virus (HIV) is the strongest risk factor for latent or new infection of tuberculosis (TB) through reduction of CD4 T-lymphocytes and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence of tuberculosis for children living with HIV. Thus, this study assessed time to develop and predictors for incidence of tuberculosis in children attending HIV/AIDS care in public hospitals: North West Ethiopia 2021. Methods. A facility-based retrospective cohort study was conducted among 421 seropositive children on antiretroviral therapy in two hospitals between January 1, 2011 and December 31, 2020. EPI-DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Tuberculosis-free survival time was estimated using the Kaplan-Meier survival curve. Bivariate and multivariable Cox regression model was fitted to identify predictors at a P value <0.05 within 95% CI. Results. In the final analysis, a total of 421 seropositive children were included, of whom, 64 (15.2%) developed tuberculosis at the time of follow-up. The mean (±SD) age of the children was 10.62 ± 3.32 years, with a median (IQR) time to develop TB that was 23.5 (IQR = ±19) months. This study found that the incidence of tuberculosis was 5.9 (95% CI: 4.7; 7.6) per 100 person-years (PY) risk of observation. Cases at baseline not taking cotrimoxazol preventive therapy (CPT) (AHR = 2.5; 95% CI, 1.4-4.7, P < 0.021), being severely stunted (AHR = 2.9: 95% CI, 1.2-7.8, P < 0.03), and having low hemoglobin level (AHR = 4.0; 95% CI, 2.1-8.1, P < 0.001) were found to be predictors of tuberculosis. Conclusion. A higher rate of tuberculosis incidence was reported in our study as compared with previous studies in Ethiopia. Cases at baseline not taking cotrimoxazol preventive therapy (CPT), being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk to developed TB incidence.

Comprehensive approach to the tuberculosis indicators assessment of the children population in the Republic of Crimea

Introduction. Childhood tuberculosis (TB) control is relevant due to the peculiarities of its course in this age group, and the TB incidence in children is an important prognostic epidemiological indicator.Aim. Use of multivariate statistical analysis to estimate and predict childhood TB indicators in the Republic of Crimea (RC).Materials and methods. The official TB statistics in the Republic of Crimea for 2014-2018 are used. The calculated means of the indicators are checked for normality using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Pearson correlation analysis is applied to determine pair correlation relationships. Stepwise multiple regression analysis is carried out to determine group conditionality of the indicators, where coefficients, with which significant pairwise correlations are found, are selected as independent variables. Based on the results, multiple regression equations are made to predict the values of dependent variables. The data is processed using Statistica 10.0 software.Results. For childhood TB incidence, strong direct correlations are established with the incidence and prevalence of pulmonary TB among children. The paired correlation coefficient between the incidence of childhood TB and childhood lung TB and the detection of active TB patients in preventive examinations of children varied in the range of 0.63-0.72. For the prevalence of TB among children, strong direct correlations were found with the incidence of TB and pulmonary TB in children. Multiple correlation coefficients for the incidence and prevalence of childhood TB exceeded the values of paired correlation coefficients and were in the range of 0.93 to 0.98 (p&lt;0.001), indicating greater significance of group conditionality of the indicators. Determination coefficients R2 were between 0.87 and 0.96. Multiple regression models were built for the childhood TB incidence, childhood lung TB incidence, childhood TB prevalence, childhood lung TB prevalence.Conclusion. The found strong direct pairwise correlations for childhood TB incidence and prevalence and childhood pulmonary TB incidence and prevalence can serve as prognostic criteria and reflect the quality of antituberculosis interventions. High values of paired correlation coefficient between childhood TB incidence and childhood pulmonary TB and detection of patients with active TB in preventive examinations of children are a criterion of quality of both TB services and primary care, which can prevent the spread of TB and improve the epidemic situation of TB in Crimea. The calculated multiple regression models for the studied indicators can serve the needs of practical forecasting in Healthcare.

Congenital and Perinatal Tuberculosis.

This review discusses the recent literature (2006-2020) about the epidemiology, clinical presentation, diagnosis, and management of infants with congenital or perinatal tuberculosis (TB). While the incidence of childhood TB is declining in the United States and worldwide, many case reports describe how clinical suspicion for neonatal TB is raised only if an ill-appearing neonate does not improve with broad-spectrum antibiotics. Furthermore, the delay in initiating appropriate anti-TB therapy often results in the need for significant cardiopulmonary support and/or an increase in mortality. This review summarizes important clinical indications in the maternal and newborn history, the evaluation of an infant with possible TB exposure, and step-by-step recommendations for the treatment and follow-up of infants with TB.

The use of reserve drugs in the chemotherapy of children and adolescents with tuberculosis

Introduction. The incidence of tuberculosis in children and adolescents is considered one of the most significant epidemiological indicators, which reflects the overall epidemic situation for tuberculosis. An urgent problem is the fact that the effectiveness of treatment of tuberculosis with MDR/XDR MBT in children and adolescents is not reflected in official statistics, and the tolerability of new anti-tuberculosis drugs in children with tuberculosis is not sufficiently studied at present. One of the drugs that can be used in the treatment of MDR-TB in children is linezolid. Objective. to evaluate the safety and efficacy of linezolid in chemotherapy regimens for drug-resistant tuberculosis in children. Results. in the structure of clinical forms of infiltrative tuberculosis — (32.0%), the primary tuberculosis complex was detected in 8 people (16.0%), TB of intra-thoracic lymph nodes also in 8 people (16.0%). MBT resistance to cycloserine and linezolid has not been reported in any patients. All patients received linezolid (100%). The development of undesirable side effects was observed in 14 people (28.0%). Linezolid caused in 3 people (6.0%) (adolescents 13 — 17 years old) undesirable adverse reactions of the type of polyneuropathy. The cessation of bacterial excretion was observed after 1 month in 100 % of cases. All children showed positive clinical dynamics and normalization of blood parameters in the period from 2 to 6 months of treatment. Positive radiological dynamics were also observed in the period from 2 to 6 months of treatment in the form of closure of the decay cavities, compaction, calcification and resorption of foci. Conclusion. Linezolid is a promising drug in children with tuberculosis who need the use of reserve drugs, since clinical efficacy is noted, MBT resistance is rarely developed, and the frequency of undesirable side reactions of regimens with the inclusion of linezolid does not exceed the frequency of those when prescribing regimens without the inclusion of linezolid

Pengaruh Faktor Sosial, Ekonomi Dan Lingkungan Terhadap Kejadian Tuberkulosis Paru Pada Anak Di Kota Jambi

Tuberculosis is a disease cause by Mycobakterium tuberculosis in children occurs on 0 -14 years old children. The purpose of this study was to analyze the influence between the social, economic and environment factors with the incidence of tuberculosis in children. This study design was case control. Examined variables were parental knowledge, birth weight, BCG immunization, house contact, smoking, parental income, ventilation, lighting, temperature, humidity and residential density was the incidence of pulmonary tuberculosis in children. Case samples were the total number of cases recorded in the TB-03 register in Jambi City, July - December 2019. Control was taken by means of the neighborhood, age and gender matching method. The number of samples was 104 people 1:1 (52 cases and 52 controls). Data collection by interview using a questionnaire, observation and measurement. Data analyzed with chi square test and binary logistic regression at 95% CI. Case characteristics in boys (61.5%) aged over 5 years. There was a influence between smoking, house contact, and bedroom lighting with the incidence of pulmonary tuberculosis in children. The social, economy and environment factors were not related to the incidence of pulmonary tuberculosis in children. The most dominant factor the incidence of tuberculosis in children is home contact with a probability of 99% supported by home lighting factors (OR = 7.35, 95% CI = 2.120 - 25.508) after being controlled by BCG immunization, smoking, bedroom temperature, house temperature and occupancy density. The research conclusion shows that Pulmonary Tuberculosis in children only happens when there is a direct contact from the grown ups who have the disease with the children and they live at the same house. This is also supported with the house lighting as the breaking factor of Mycobacterium Tuberculosis bacteria.

Tuberculosis in children in Russia

The objective: analysis of tuberculosis situation among the pediatric population of Russia. Subjects: the data from Federal Statistics Forms no. 8, 30, 33, 47, and 61 were studied. The number of those died is presented as per the data of Rosstat. Research methods: epidemiological and statistical analysis, expert assessment, and content analysis of publications and regulations. Results. In 2005-2019, tuberculosis rates among children and adolescents of 0-17 years old decreased: incidence – from 21.5 to 9.0 per 100,000 children (2.4 times), prevalence – from 28.3 to 10.6 per 100,000 children (2.7 times), mortality – from 0.22 to 0.03 per 100,000 children (7.3 times). The incidence of tuberculosis in children of 0-14 years old decreased from 16.4 to 7.7 per 100,000 children (2.1 times), children of 15-17 years old – from 37.6 to 16.5 per 100,000 children (2.3 times). Boys suffer from tuberculosis less often than girls. The decrease in tuberculosis incidence in children is directly related to the overall improvement of tuberculosis situation in the country including the reduction of exposure to tuberculosis by 2.2 times. In the structure of tuberculosis incidence, the proportion of lung damage increases, while the proportion of other localizations in respiratory organs and extrapulmonary lesions decreases. From 2005 to 2019 among children of 0-14 years old, the proportion of lung damage increased from 18.0 to 32.1%, and among children 15-17 years old – from 80.8 to 89.1%. From 2005 to 2019, among children and adolescents aged 0-17 years notified with tuberculosis at the end of the year, the proportion of those HIV infected increased up to 3.4%, while the absolute number of children decreased down to 108. The proportion of children with MDR TB among those with a positive result of sputum test increases (2005 – 10.0%; 2019 – 45.8%). From 2005 to 2019, the rate of those died of tuberculosis decreased among children of 0-14 years old from 0.17 to 0.02 per 100,000 children (8.5 times), at the age of 15-17 years – from 0.22 to 0.07 per 100,000 children (3.1 times). The number of children aged 0-14 years, registered with post-vaccination complications decreased by 6.2 times (2005 – 947 children, 2019 – 153 children).

Risk Factor of Tuberculosis in Children with Nephrotic Syndrome who Received Immunosuppressant Therapy in Hasan Sadikin Hospital

Patients with nephrotic syndrome (NS) are in immunocompromised condition due to illness and therapy given. Treatment of NS with long-term steroids, high doses and combination with cyclophosphamide decreases body resistance. Immunocompromised conditions facilitate the occurrence of infection, one of the infections that might occur is tuberculosis (TB) with a high incidence in Indonesia. The aim of the study was to investigate the risk factors of TB in children with NS, specifically related to the duration of steroids administration, and combinations of steroids with cyclophosphamide. This was cross sectional study data retrieval from out-patients and in-patients NS children in RS Hasan Sadikin Bandung (RSHS) during 1st January 2012 until 31st December 2016. Statistical analysis using chi-square test and multiple logistic regression. There were 34 children with TB from 199 NS patients, the prevalence of TB in children with NS in RSHS (17%). The results showed that duration of steroids administration, combination of steroids and cyclophosphamide, female gender, and under nutrition were significant to tuberculosis incidence (p <0.001). Multiple logistic regression analysis revealed duration of steroid 175,5 days OR 20,7 (CI95% 7,5-68,1); p<0.001, combination of steroids with cyclophosphamide OR 3,2 (CI95% 1,1-11,7); p=0,027, female gender OR 2,5 (CI95% 0,9-7,2); p=0,077, and under nutrition OR 7,2 (CI95% 2,4-3,7); p=0.001. Duration of steroid administration, combination of steroids with cyclophosphamide, female gender, and under nutrition were risk factors for tuberculosis. The duration of steroid administration was the most dominant factor in the incidence of tuberculosis in children with NS.

ЭПИДЕМИЧЕСКАЯ СИТУАЦИЯ ПО ТУБЕРКУЛЕЗУ У ДЕТЕЙ В КАЛУЖСКОЙ ОБЛАСТИ В 2014-2018 ГГ.

Purpose: to study tuberculosis situation in children in Kaluga Region in 2014-2018. Subjects and methods . Tuberculosis incidence in children was analyzed and compared with tuberculosis rates in adults in 2014-2018. The primary infection of children with tuberculous mycobacteria, the structure of Dispensary Groups III and IV were studied. All new tuberculosis cases in children aged 0 to 17 years in 2014-2018 were analyzed. Results. In 2014-2018, there were mixed trends in tuberculosis incidence in children in Kaluga Region. The rate of tuberculosis incidence growth made 0.9%, which was higher than the growth in the overall incidence rate and indirectly indicated the presence of infection sources among adult population. No statistically significant correlation was found between the overall incidence of tuberculosis and the incidence of tuberculosis with a positive result of sputum test (r = 0.9; p &gt; 0.05), as well as between the incidence of tuberculosis with with a positive result of sputum test and tuberculosis incidence in children (r = -0.48; p &gt; 0.05). This points out at defects in the work of laboratory service as well as a poor detection of children exposed to infectious tuberculosis cases. In Kaluga Region, the average incidence in children registered as contacts of a tuberculosis case made 809.7 ± 306.1 per 100,000 children exposed to tuberculous infection in 2014-2018.

Contextual Effect of Village on the Incidence of Tuberculosis in Children in Surakarta, Central Java: A Multilevel Analysis Evidence

Background: Indonesia is in the second place with the highest burden of tuberculosis (TB) in the world. Childhood is a period of rapid growth that requires efforts to maintain children's health. At the time the child still has a low immune system making it vulnerable to a disease including TB. The problem of TB in children requires better attention in child TB control programs. This study aimed to analyze the contextual influence of villages on the incidence of TB in children. Subjects and Method: This was a case-control study conducted in 25 villages in Surakarta, Central Java, from August to September 2019. A sample of 200 children aged 0 to 18 years was selected by fixed disease sampling. The dependent variable was the incidence of TB in children. The in­de­pen­dent variables were birth weight, BCG immunization, exclusive breastfeeding, nutritional sta­tus, parental income, home sanitation, exposure to cigarette smoke, family history of TB, and con­­textual effect of village. Data on TB were obtained from medical record in Su­­rakarta community health center. The other data was collected by questionnaire. The data was analyzed by multilevel mul­tiple logistic regression with Stata 13. Results: The risk of TB in children increased poor house sanitation (OR= 6.70; 95% CI= 1.14 to 39.27; p= 0.035), high exposure to cigarette smoke (OR= 6.71; 95% CI= 1.09 to 41.25; p= 0.040), and family history of TB (OR= 6.01; 95% CI= 1.36 to 26.39; p= 0.018). The risk of TB in children decreased with normal birth weight (≥2500 g) (OR= 0.12; 95% CI= 0.02 to 0.60; p= 0.009), BCG immunization (OR= 0.17; 95% CI= 0.04 to 0.64; p= 0.009 ), exclusive breastfeeding (OR= 0.08; 95% CI= 0.01 to 0.57; p= 0.011), good nutri­tio­nal status (OR= 0.11; 95% CI= 0.02 to 0.66; p= 0.016), and parental income ≥Rp 1,802,700 (OR= 0.07; 95% CI= 0.01 to 0.37; p= 0.002). Village had strong contextual effect on the risk of TB in children with intra-class correlation (ICC)= 29.24%. Conclusion: The risk of TB in children increases poor house sanitation, high exposure to cigarette smoke, and family history of TB. The risk of TB in children decreases with birth weight ≥2500 g, BCG immunization, exclusive breastfeeding, good nutri­tio­nal status, and high parental income. Village has strong contextual effect on the risk of TB in children. Keywords: Tuberculosis, risk factors, children aged 0-18 years, multilevel analysis. Correspondence: Dyah Ayu Saputri. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: ayusaputridyah7@gmail.com. Mobile: 081353236388. Journal of Epidemiology and Public Health (2019), 4(4): 361-372 https://doi.org/10.26911/jepublichealth.2019.04.04.11

Analysis of Factors Associated with Pulmonary Tuberculosis Incidence of Children in Sibuhuan General Hospital

Background: Pulmonary TB patients in Indonesia increase from 1997 to 2014. In 2013 cases of pulmonary TB in children and toddlers have started to be detected in children with age group &lt; 1 year as much as ‰, children with age group 1-4 years as many as 4‰ and children with 5-14 years age group as much as 0.3‰. Purpose: This study aimed to determine the factors that associated with the incidence of pulmonary tuberculosis in Sibuhuan Hospital. Methods: This research used crossectional design and conducted in RSUD Sibuhuan Padang Lawas. The population in this study was all children aged 0-5 years who came treated to lung clinic Sibuhuan RSUD as many as 55 children. Analysis of this study was using chi-square test and measured Pravelence Ratio (PR) to analyze factors related to childhood tuberculosis incident. Results: Children with pulmonary tuberculosis occurred in respondents with male gender as many as 33 children (60%), normal nutritional status as many as 35 children (63,60%), low socioeconomic counted 32 children (58,2%), not getting BCG immunization as many as 32 people (58,2%). There was association between nutritional status (PR = 3,31; 95% CI =1,83 &lt; PR &lt; 5,98), sosioeconomic (PR= 5,51; 95% CI =1,88&lt; PR&lt; 16,182), and BCG immunization (PR = 2,59; CI = 1,15 &lt; PR &lt; 5,33) with incidence of childhood tuberculosis in RSUD Sibuhuan. Conclusion: There was significant between nutritional status, socioeconomic and BCG immunization with incidence of childhood tuberculosis in RSUD Sibuhuan.