Pediatric TB Patients Research Articles

Health profile of paediatric tuberculosis patients on directly observed treatment short course therapy

Background: Children are especially vulnerable to tuberculosis due to close contact with family members and it is often difficult to diagnose and treat it in young children. The objective of this study was to study clinical profile of paediatric TB patients. To assess outcome of directly observed treatment short course (DOTS) among paediatric TB patients. Methods: A descriptive longitudinal study conducted in all paediatric (1-15 years) patients registered for tuberculosis treatment in city tuberculosis center Solapur during 1 st November 2010 to 31 st December 2012. A pre-designed, pre-tested structural questionnaire was used for data collection. Physical examination was undertaken after the interview was over . Results: 93 paediatric TB patients were registered for DOTS. Male to female patient’s ratio was almost equal. Most of the TB patients (35.56%) were in 01 to 05 years of age group. Most of the patients (91) presented with cough for more than two weeks; with other symptoms like evening rise of fever, dyspnea, loss of appetite, swelling over neck. Out of 93 patients 70 patients had protein energy malnutrition (PEM). 84.95% patients were completed the DOTS treatment, while 3.22% were defaulter and outcome in 1.05% was treatment failure. Conclusions: DOTS completion rate among paediatric TB patients is considerably high, protein energy malnutrition have the association with paediatric tuberculosis.

Diagnostic values of microRNA-31 in peripheral blood mononuclear cells for pediatric pulmonary tuberculosis in Chinese patients.

We investigated the diagnostic values of microRNA-31 in peripheral blood mononuclear cells (PBMCs) for pediatric pulmonary tuberculosis in Chinese patients. Sixty-five children with TB were selected for this study, which was conducted at the Department of Infectious Diseases People's Hospital of Laiwu City between December 2013 and December 2014. Sixty healthy children, selected in parallel, served as the control group. Real-time PCR was used to detect miR-31 expression in PBMCs. Serum levels of IL-6, TNF-α, NF-κB, and IFN-γ was detected by ELISA. ROC curve was employed to evaluate the diagnostic value of miR-31 in pediatric TB. Results show that expression of miRNA-31 in pediatric TB patients was significantly lower than that in normal children (0.48 ± 0.15 vs 1.23 ± 0.36, P < 0.05). By contrast, serum levels of the innate immune response cytokines, IL-6, TNF-α, NF-κB, and IFN-γ, were significantly higher in pediatric TB patients compared with normal children (P < 0.05). Furthermore, miRNA-31 expression was negatively correlated with serum levels of IL-6 (t = 69.91, P < 0.001), TNF-α (t = 10.96, P < 0.001), NF-κB (t = 39.94, P < 0.001), and IFN -γ (t = 37.94, P < 0.001). The cut-off threshold of miR-31 for pediatric TB diagnosis is 0.835 with a sensitivity of 98.5% and a specificity of 86.7%. Therefore, miR-31 has the potential to be a diagnostic marker in pediatric TB patients.

High proportion of multidrug resistant Mycobacterium tuberculosis among children in Pakistan

Aims and objectivesTuberculosis (TB) in children is an important predictor of ongoing transmission within a population. Pakistan has a high TB and multidrug resistant (MDR) TB burden, putting children at high risk for acquiring the disease. Despite this high MDR burden status, MDR TB rates have not been reported in children from Pakistan. MethodsAga Khan University mycobacteriology laboratory TB culture and susceptibility records have been reviewed for samples received from children 0–14years of age from all over Pakistan. Specimens were further segregated by age, site (pulmonary vs. extrapulmonary), and drug resistance profile. ResultsOf 50,048 specimens received for culture between 2009 and 2012, only 2.1% (n=1059) were obtained from children. Culture positivity rate among children was 1.5 times higher than that seen in adults (37.7% vs. 24.2%). Of 399 positive cultures, 72.9% (n=291) were pulmonary, while 37.1% (n=108) were extrapulmonary, and 73.9% (n=295) were obtained from females, while 26.1% (n=104) were obtained from males. Susceptibility testing revealed 41.4% (n=164) of isolates to be MDR, 89.1% (n=147) of which had a pulmonary source (i.e., gastric aspirates, bronchial washings, or sputa). MDR TB also showed an older-age predominance where 89.1% (n=147) of MDR was seen in the 10–14 age group. About half (50.9%; n=203) of all Mycobacterium tuberculosis isolates from children were isoniazid mono-resistant. ConclusionsAlthough pediatric specimens comprise only a small proportion of specimens received for mycobacterial culture, the culture positivity rate is much higher among children than in adults, reflecting a need to encourage culture testing of suspected pediatric TB patients. Predominance of positive cultures among female children and MDR TB in the older age groups highlights the need for focus on control efforts among this demographic.

Health and socio-demographic profile of paediatric tuberculosis patients on dots therapy in Ahmedabad city

Background: Children are especially vulnerable to the effects of tuberculosis, which is often difficult to diagnose in young children and therefore difficult to treat effectively. Aims & Objectives: To study profile of pediatric TB patients who are on DOTS therapy in Ahmedabad Municipal Corporation (AMC) area during April-June, 2011. Materials and Methods: This study was cross sectional study carried out in 100 pediatric patients of tuberculosis out of 197 registered during April 2011 to June 2011 from all TB units (10 units) in AMC area. Data analysis was done using SPSS software. Results: Out of 100 patients, 60 were female and 40 were male. Age range was 1-14 year. Mean age of children was 8.63 ± 3.66 years. Mean age of male patients was 9.36 ±3.16 years. Mean age of female patients was 7.53 ± 4.10 years. According to modified Prasad’s classification, 78% patients belonged to lower socioeconomic class. 94% patients were in Category-1 and 79% had extra pulmonary TB. 4% patients had HIV infection. Parents of 90% patients didn’t have knowledge of TB. 60% of patients preferred syrup formulation, if available. Conclusion: Apart from pharmacological treatment poor knowledge of Pediatric TB in Parents of patients also needs great attention.

Characteristics of adults and children diagnosed with tuberculosis in Lilongwe, Malawi: findings from an integrated HIV/TB clinic

To describe initial registration characteristics of adult and paediatric TB patients at a large, public, integrated TB and HIV clinic in Lilongwe, Malawi, between January 2008 and December 2010. Routine data on patient with TB category and TB type, stratified by HIV and ART status, were used to explore differences in proportions among TB only, TB/HIV co-infected patients not on ART and TB/HIV co-infected patients on ART using chi-square tests. Trends over time illustrate strengths and weaknesses of integrated service provision. Among 10 143 adults, HIV ascertainment and ART uptake were high and increased over time. The proportion of relapse was highest among those on ART (5%). The proportion of smear-positive pulmonary TB (PTB) was highest among HIV-negative patients with TB (34.9%); extra-pulmonary TB (EPTB) was lowest among TB only (16.2%). Among 338 children <15 years, EPTB and smear-positive PTB were more common among TB-only patients. Time trends showed significant increases in the proportion of adults with smear-positive PTB and the proportion of adults already on ART before starting TB treatment. However, some co-infected patients still delay ART initiation. HIV ascertainment and ART uptake among co-infected patients are successful and improving over time. However, delays in ART initiation indicate some weakness linking TB/HIV patients into ART during TB follow-up care. Improved TB diagnostics and screening efforts, especially for paediatric patients, may help improve quality care for co-infected patients. These results may aid efforts to prioritise TB and HIV prevention, education and treatment campaigns for specific populations.

S27 Should routine screening for vitamin d deficiency be incorporated into current guidelines for treatment of paediatric TB patients?

Introduction and ObjectivesThe association between low vitamin D levels and increased severity/susceptibility to TB infection due to suppression of innate immunity is well known. In the United Kingdom, low levels...