Pediatric Tuberculosis Research Articles

Pediatric Tuberculosis Infection Care Facilitators and Barriers: A Qualitative Study.

A total of 700 000 US children and adolescents are estimated to have latent tuberculosis (TB) infection. Identifying facilitators and barriers to engaging in TB infection care is critical to preventing pediatric TB disease. We explored families' and clinicians' perspectives on pediatric TB infection diagnosis and care. We conducted individual interviews and small group discussions with primary care and subspecialty clinicians, and individual interviews with caregivers of children diagnosed with TB infection. We sought to elicit facilitators and barriers to TB infection care engagement. We used applied thematic analysis to elucidate themes relating to care engagement, and organized themes using a cascade-grounded pediatric TB infection care engagement framework. We enrolled 19 caregivers and 24 clinicians. Key themes pertaining to facilitators and barriers to care emerged that variably affected engagement at different steps of care. Clinic and health system themes included the application of risk identification strategies and communication of risk; care ecosystem accessibility; programs to reduce cost-related barriers; and medication adherence support. Patient- and family-level themes included TB knowledge and beliefs; trust in clinicians, tests, and medical institutions; behavioral skills; child development and parenting; and family resources. Risk identification, education techniques, trust, family resources, TB stigma, and care ecosystem accessibility enabled or impeded care cascade engagement. Our results delineate an integrated pediatric TB infection care engagement framework that can inform multilevel interventions to improve retention in the pediatric TB infection care cascade.

The Importance of Involving a Multidisciplinary Team in the Management of a Patient Diagnosed with TB, Associating Erythema Nodosum

Tuberculosis (TB) is an important and topical problem at global level, so it remains a challenge for public health policies . According to the World Health Organization (WHO), in 2018, about 10 million new TB cases worldwide were estimated. Of these, 11% are children under the age of 15. In addition to these alarming data, TB is responsible for 130,000 deaths per year in children and it is estimated that there are approximately 1 million TB-cases in the global population of children, being one of the top 10 causes of death in children worldwide. According to the WHO, there are economic, social, cultural, ethnic/racial, psychological and behavioral factors that interfere with the occurrence of diseases, and these factors are attributed to the persistence of infectious diseases such as TB in the population, even today. Numerous specialized studies strengthen the hypothesis of associating social vulnerability with TB emergence and distribution in the community.
 Therefore, the development of more accurate estimates of pediatric TB cases is an urgent need for public policy scheduling and resource allocation and, consequently, for reducing morbidity and mortality from TB among children.

Improving TB detection among children in routine clinical care through intensified case finding in facility-based child health entry points and decentralized management: A before-and-after study in Nine Sub-Saharan African Countries.

In 2022, an estimated 1.25 million children <15 years of age developed tuberculosis (TB) worldwide, but >50% remained undiagnosed or unreported. WHO recently recommended integrated and decentralized models of care as an approach to improve access to TB services for children, but evidence remains limited. The Catalyzing Paediatric TB Innovation project (CaP-TB) implemented a multi-pronged intervention to improve TB case finding in children in nine sub-Saharan African countries. The intervention introduced systematic TB screening in different facility-based child-health entry-points, decentralisation of TB diagnosis and management, improved sample collection with access to Xpert® MTB/RIF or MTB/RIF Ultra testing, and implementation of contact investigation. Pre-intervention records were compared with those during intervention to assess effect on paediatric TB cascade of care. The intervention screened 1 991 401 children <15 years of age for TB across 144 health care facilities. The monthly paediatric TB case detection rate increased significantly during intervention versus pre-intervention (+46.0%, 95% CI 36.2-55.8%; p<0.0001), with variability across countries. The increase was greater in the <5 years old compared to the 5-14 years old (+53.4%, 95% CI 35.2-71.9%; p<0.0001 versus +39.9%, 95% CI 27.6-52.2%; p<0.0001). Relative contribution of lower-tier facilities to total case detection rate increased from 37% (71.8/191.8) pre-intervention to 50% (139.9/280.2) during intervention. The majority (89.5%) of children with TB were identified through facility-based intensified case-finding and primarily accessed care through outpatient and inpatient departments. In this multi-country study implemented under real-life conditions, the implementation of integrated and decentralized interventions increased paediatric TB case detection. The increase was driven by lower-tier facilities that serve as the primary point of healthcare contact for most patients. The effect was greater in children < 5 years compared to 5-14 years old, representing an important achievement as the TB detection gap is higher in this subpopulation. (Study number NCT03948698).

Evaluation of a short training course of chest X-ray interpretation for the diagnosis of paediatric TB.

Chest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries. Within the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features. We performed a pre-post training assessment on a pre-defined set of 20 CXR readings. We compared the proportion of correctly interpreted CXRs and the median reading score before and after the training using the McNemar test and a linear mixed model. Of 191 HCWs, 43 (23%) were physicians, 103 (54%) nurses, 18 (9.4%) radiology technicians and 12 (6.3%) other professionals. Of 2,840 CXRs with both assessment, respectively 1,843 (64.9%) and 2,277 (80.2%) were correctly interpreted during pre-training and post-training (P < 0.001). The median reading score improved significantly from 13/20 to 16/20 after the training, after adjusting by country, facility and profession (adjusted β = 3.31, 95% CI 2.44-4.47). Despite some limitations of the course assessment that did not include abnormal non-TB suggestive CXR, study findings suggest that a short CXR training course could improve HCWs' interpretation skills in diagnosing paediatric TB.

Prevalence of Latent Tuberculosis Infection Among Nurses Working in Critical Areas at a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Introduction Tuberculosis is a critical health issue worldwide.Most infected persons are asymptomatic and categorized as having a latent tuberculosis infection (LTBI). Healthcare workers (HCWs) are more prone to being infected with tuberculosis and should be enrolled in a screening program for early detection. Objectives The study aims to estimate the prevalence of LTBI among nurses working in critical areas which include adult intensive care units, pediatric intensive care units, emergency departments, oncology departments, dialysis departments, tuberculosis labs, isolation rooms, and cardiac center intensive care units. Methods A record-based cross-sectional survey measured the prevalence of LTBI among nurses working in critical areas at Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia. We reviewed the occupational health records of all nurses working in critical areas from June 1, 2021, to June 1, 2022. We recorded the data reviewed throughout the year in the Occupational Health Department at PSMMC. We excluded all participants with previously documented positive tuberculin skin test (TST) from the study. We analyzed the sociodemographic data, working years, working location, job title, and TST results. Results We included a total of 771 out of 2025 nurses in this study. Participants were mostly women (88%) and in the 26-35-year age group (67.7%). Most of the participants were originally from the Philippines (66.3%). The overall LTBI prevalence among nurses was 34.5%. The highest prevalence of LTBI was among nurses working in the cardiac intensive care unit (53.5%), and the lowest prevalence was among nurses working in the isolation department (8.9%; p-value <0.0001). Those who worked more in the hospital were significantly more infected with LTBI (p-value <0.04). Conclusion LTBI remains a significant health risk worldwide andin the Middle East as well as among HCWs. This underscores the necessity of comprehensive pre-hiring screening, annual screening, infection control protocols, and active management of HCWs with LTBI.

CHILDHOOD TUBERCULOSIS: STUDY OF CLINICAL PROFILE OF TUBERCULOSIS IN PEDIATRIC PATIENTS AND CORRELATION OF CB-NAAT RESULT IN CLINICALLY SUSPECTED TUBERCULOSIS

Introduction: Tuberculosis is a chronic infectious disease caused by predominantly Mycobacterium tubercle bacilli. Pediatric tuberculosis is among the top 10 causes of death in children. India accounts for one fourth of the global tuberculosis burden, standing one among the thirty high TB burden countries. Hence, children in India are at increased risk of acquiring TB infection and developing TB disease and death following infection. Latent TB infection in children may be reactivated in later life and become active adulthood tuberculosis and thereby a potent TB reservoir in the community. Aim: To study clinical profile of tuberculosis in pediatric patients and correlation of CB-NAAT result in clinically suspected tuberculosisat tertiary care center. Method: Prospective Observational study from1 August 2020 to 31 August 2022. Result: Out of 52 patients cough was presenting symptom of 19(36.53%), fever was present in 25(48.07%), loss of weight &gt;5% in last 3 month was present in 12(23.07%),fever(83.8 %) was most dominant symptom. Out of 52 patients, tachypnoea was presenting sign in 5(9.6%), ascites was present in 5(9.6%) and lymphadenopathy for more than 2 weeks were present in 25(48.07%). Out of 52 patients Anaemia was present in 42(80.76%), High ESR was present in 22(42.30%) and Mantoux test was positive in 16(30.76%). Conclusion: Reliable diagnosis of tuberculosiscan be done by clinical parameters like presence of tachypnea, fever and lymphadenopathy. CB NAAT in correlation to clinical parameters is very useful for diagnosis of tubercular cases.

Mediastinal Tuberculosis with Sternal Encroachment - A Rare Presentation of Tuberculosis

Introduction Extra-pulmonary tuberculosis constitutes 15-20% of the total tuberculosis (TB) caseload in immunocompetent patients. Affliction of the skeletal system is rare with still rarer presentation of sternal tuberculosis. Sternum is one of the least common bones of the body to get infected (1) Sternal TB is predominantly seen in middle-aged adults although no age is immune and it has also been reported in an infant. It can arise primarily due to a hematogenous route or direct extension from the hilar lymph nodes and/or could be due to lymphatic disseminatio(2) . Sternal tuberculosis has also been reported after BCG vaccination in the pediatric age group (3-5) Here we present an unusual case of tuberculosis of the sternum, which presented with swelling and pain in the chest in a 9 year old boy. Keywords: Sternal tuberculosis, Manubrium sterni, Skeletal Tuberculosis, Pediatric sternal tuberculosis, Mediastinal Koch’s

Upaya Pencegahan Tuberkulosis Anak di Kelurahan Koto Baru Nan XX Lubuk Begalung Kota Padang

Tuberculosis (TB) in children (aged 0-14 years) is a disease caused by the bacteria Mycobacterium tuberculosis. WHO estimates that in 2021 as many as 10.6 million people will be infected with TB worldwide. Six million of them are men, 3.4 million women and 1.2 million children. This community service was carried out at the Koto Baru Nan XX Village Head Office with 20 health cadres on duty at the posyandu. Community service activities consist of education about childhood TB. Apart from that, a pre-test and post-test were also carried out to determine the level of knowledge of community service participants before and after the training. The data was then analyzed using the Wilcoxon test. It is known that there is a significant difference between the level of knowledge before and after counseling regarding pediatric TB among health cadres in Koto Baru Nan XX Lubuk Begalung Village, Padang City. It is hoped that with this activity, health cadres can convey this knowledge to the community, including those present at the posyandu which is held once a month.

Pediatric miliary tuberculosis diagnosed by endobronchial ultrasound-guided biopsy.

Pediatric miliary tuberculosis diagnosed by endobronchial ultrasound-guided biopsy.

Nanotechnological innovations in paediatric tuberculosis management: current trends and future prospects

Paediatric Tuberculosis (TB) continues to be a major global cause of morbidity and mortality. Children are more prone to contracting TB, which can spread quickly to extrapulmonary infection sites. Although the pathophysiology of the disease, drug pharmacokinetics, and the therapeutic window in children differ from those of adults, the same drugs used to treat adult TB have long been utilised to treat paediatric TB infections. Since many current formulations such as tablets are unsuitable for children due to difficulty swallowing and risk of choking, adult medications are frequently used by breaking or crushing tablets to obtain a paediatric dose. This can result in inaccurate dosing due to pharmacokinetic differences in children which could subsequently lead to sub-therapeutic or toxic systemic concentrations. In addition, many of the medications used in the treatment of TB and most medicines in general, have a profoundly unpleasant taste to children causing them to reject and spit out medication which contributes to challenges with adherence, ultimately leading to treatment failure. The aforementioned demonstrates a huge need for the development of novel drug delivery formulations that are paediatric-friendly and address the limitations of current dosage forms. This review discusses the currently available oral paediatric formulations, recent developments of novel oral drug delivery systems studied to overcome the current problems associated with the treatment of tuberculosis in paediatrics and provides potential direction for future research through nanotechnology by using a SWOT analysis.

Evaluation of radiological capacity and usage in paediatric TB diagnosis: A mixed-method protocol of a comparative study in Mozambique, South Africa and Spain.

Tuberculosis remains one of the top ten causes of mortality globally. Children accounted for 12% of all TB cases and 18% of all TB deaths in 2022. Paediatric TB is difficult to diagnose with conventional laboratory tests, and chest radiographs remain crucial. However, in low-and middle-income countries with high TB burden, the capacity for radiological diagnosis of paediatric TB is rarely documented and data on the associated radiation exposure limited. A multicentre, mixed-methods study is proposed in three countries, Mozambique, South Africa and Spain. At the national level, official registry databases will be utilised to retrospectively compile an inventory of licensed imaging resources (mainly X-ray and Computed Tomography (CT) scan equipment) for the year 2021. At the selected health facility level, three descriptive cross-sectional standardised surveys will be conducted to assess radiology capacity, radiological imaging diagnostic use for paediatric TB diagnosis, and radiation protection optimization: a site survey, a clinician-targeted survey, and a radiology staff-targeted survey, respectively. At the patient level, potential dose optimisation will be assessed for children under 16 years of age who were diagnosed and treated for TB in selected sites in each country. For this component, a retrospective analysis of dosimetry will be performed on TB and radiology data routinely collected at the respective sites. National inventory data will be presented as the number of units per million people by modality, region and country. Descriptive analyses will be conducted on survey data, including the demographic, clinical and programmatic characteristics of children treated for TB who had imaging examinations (chest X-ray (CXR) and/or CT scan). Dose exposure analysis will be performed by children's age, gender and disease spectrum. As far as we know, this is the first multicentre and multi-national study to compare radiological capacity, radiation protection optimization and practices between high and low TB burden settings in the context of childhood TB management. The planned comparative analyses will inform policy-makers of existing radiological capacity and deficiencies, allowing better resource prioritisation. It will inform clinicians and radiologists on best practices and means to optimise the use of radiological technology in paediatric TB management.

Pediatric ocular tuberculosis: a case report of complex clinical manifestations and its successful management

Pediatric ocular tuberculosis: a case report of complex clinical manifestations and its successful management

Effect of delamanid on interim outcomes of bacteriological conversion amongst pediatric drug resistant tuberculosis cases in India.

To determine the bacteriological conversion rate after 6 months of Delamanid (DLM) based treatment in children with drug-resistant tuberculosis (DR-TB) and determine factors associated with bacteriological conversion. This is a descriptive retrospective study done in children between the age of 6-17 years with DR-TB who received DLM-based therapy from October 2018 to May 2021. The drug resistance pattern of TB was detected using Xpert RIF/MTB and phenotypic drug sensitivity testing (DST) on TB-MGIT culture reports. Follow-up sputum TB MGIT culture was carried out monthly after DLM initiation for 6 months. Factors associated with sputum bacteriological conversion such as age, gender, pulmonary TB (PTB) versus disseminated TB, unilateral or bilateral lung involvement, type of DR-TB, prior treatment failure, and type of DR-TB regimen were analyzed. Sixty patients received DLM of which two had extrapulmonary TB (EPTB) and sputum conversion could not be assessed. The mean age at presentation was 12.69 ± 3.03 years. Five patients (8.3%) died while on DLM treatment. On follow-up, 8 (13.7%) out of 58 patients had no sputum bacteriological conversion after 6 months of DLM initiation of which three patients were on salvage therapy; 46 (79.3%) had sputum bacteriological conversion within 6 months of DLM initiation. Sputum bacteriological conversion rate was almost 80% at the end of 6 months of DLM-based treatment.

Analysis Of The Nutritional Status Of Pediatric Tuberculosis Patients After Treatment At The X General Hospital Center

Introduction: Indonesia is currently ranked 2nd in the country with the highest number of tuberculosis (TB) cases. TB disease in children cannot be separated from the role of nutritional status. Poor nutrition can cause immunological disorders and affect the disease healing process. Methodology: The research method used was cross-sectional which was carried out at Central General Hospital X in July 2019. A sample of 72 pediatric tuberculosis patients was taken using a simple random sampling technique. The data used is secondary data from medical records for the period January 2016-December 2018 to look at the characteristics of pediatric TB patients and analyze the evaluation of nutritional status after treatment. Data analysis used the non-parametric Wilcoxon test. Results: The highest age was in the 5-14 year category (51.4%). In the Wilcoxon test, a p-value of 0.000 (&lt;0.05) was obtained, which stated that there was a significant difference between nutritional status before and after treatment. Conclusion: Compliance with pediatric TB patients in undergoing treatment will improve the patient’s nutritional status.

Telenursing Intervention for Pulmonary Tuberculosis Patients - A Scoping Review.

Management of care for people with Pulmonary TB at home using Information and Communication Technology (ICT) tools and innovative approaches, such as tools for telecommunications online education. In the nursing sector, the use of telecommunications is called telenursing. The purpose of this study is to determine the types of telecommunications-based interventions, especially telenursing, in monitoring the level of treatment adherence in patients with pulmonary TB. This study used a scoping review method approach to determine the type of telecommunications-based interventions, especially telenursing, in monitoring the level of treatment adherence in patients with pulmonary TB. Literature distribution using several sources, namely EBSCOhost, Scopus (Elsevier), and PubMed. To facilitate obtaining appropriate literature, PICO techniques are used in conducting literature searches, P (population/problem/patient), I (intervention, prognostic factor, exposure), C (comparison, control), and O (outcome). Keywords used in English "Tuberculosis OR Pulmonary Tuberculosis AND Telehealth OR Telehealth Nursing AND Medication Adherence OR Medication Compliance OR Behavior". In total from the 13 articles obtained, the articles used several telehealth to pulmonary TB patients with various implementations, such as the Directly Observed Therapy, Short Course (DOTS) (n = 7). These four implementations have the same goal and support adherence to taking medication and daily recovery in pulmonary TB patients. Overall characteristics of pulmonary TB patients in the reviewed articles are pediatric TB patients (0-14 years), adult TB (18-30 years). A total of 9 studies used a sample population of adult TB patients (18-30 years), TB undergoing Directly Observed Treatment Short-course (DOTS), TB receiving medical care and TB patients actively receiving treatment. The most influential effectiveness of telehealth in helping the treatment process of Pulmonary TB patients is Directly Observed Treatment Short-course (DOTS) because the main focus of the DOTS strategy is patient discovery and cure, priority is given to infectious TB patients without ruling out other types of TB.

Recent advances in drug therapy for tuberculosis

Despite global efforts to control and eradicate tuberculosis (TB), it remains a significant source of morbidity and mortality worldwide. Drug-resistant TB (DRTB) is a significant public health threat with implications for global health security, economic burden, and access to quality care. To address this challenge, continued investment in research, surveillance, and innovative strategies is crucial. Collaboration among international organizations, governments, and health-care systems is crucial to tackle this global health concern effectively. Bedaquiline (BDQ), a diarylquinoline drug, is indicated for combination therapy in adult patients with pulmonary multidrug-resistant TB (MDRTB). The Food and Drug Administration (FDA) granted accelerated approval in December 2012, based on analysis of time to sputum culture conversion from two phase 2 trials. The World Health Organization (WHO) published interim policy guidance for BDQ in conjunction with WHO-recommended MDRTB treatments in June 2013. The European Medicines Agency authorized Delamanid as a first-in-class bicyclic nitroimidazole for treating MDRTB, which has been used in 89 and 54 nations due to its quick acquisition of resistance. To prevent resistance, combined therapy with additional anti-TB drugs is advised, along with proper use and drug resistance monitoring. Pretomanid received approval from the US FDA in August 2019 after a phase III trial yielded encouraging results. The bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM) regimen, a component of the BPaLM regimen, has been approved for treating adults with extensive pulmonary DRTB or treatment-intolerant or non-responsive MDRTB. This significant advancement in management offers improved clinical outcomes and quality of life for MDRTB patients. The inclusion in the WHO guidelines is encouraging for global combat against DRTB. Researchers have identified and investigated new drug targets within the TB pathogenesis, offering promising avenues for the development of innovative anti-TB drugs. Advances in pediatric TB treatment have made significant progress, focusing on improved diagnostic methods, effective drug treatments, and global initiatives. Nanotechnology has shown promising potential in various fields, including medicine and TB treatment.

Novel RNA biomarkers improve discrimination of children with tuberculosis disease from those with non-TB pneumonia after in vitro stimulation.

The diagnosis of pediatric tuberculosis (TB) poses a challenge for clinical teams worldwide. TB-mediated changes in the expression of host genes in the peripheral blood can serve as diagnostic biomarkers and can provide better insights into the host immune mechanisms of childhood TB. Peripheral blood mononuclear cells (PBMCs) from children (n=102) with microbiologically confirmed TB disease, TB infection (TBI), pneumonia, and healthy controls (HC) were stimulated with either the Purified Protein Derivative (PPD) or the Early Secretory Antigen 6kDa-Culture Filtrate Protein 10 (ESAT6-CFP10) complex of Mycobacterium tuberculosis (Mtb). RNA was extracted and quantified using gene expression microarrays. Differential expression analysis was performed comparing microbiologically confirmed TB to the other diagnostic groups for the stimulated and unstimulated samples. Using variable selection, we identified sparse diagnostic gene signatures; one gene (PID1) was able to distinguish TB from pneumonia after ESAT6-CFP10 stimulation with an AUC of 100% in the test set, while a combination of two genes (STAT1 and IFI44) achieved an AUC of 91.7% (CI95% 75.0%-100%) in the test set after PPD stimulation. The number of significantly differentially expressed (SDE) genes was higher when contrasting TB to pneumonia or HC in stimulated samples, compared to unstimulated ones, leading to a larger pool of candidate diagnostic biomarkers. Our approach provides enlightened aspects of peripheral TB-specific responses and can form the basis for a point of care test meeting the World Health Organization (WHO) Target Product Profile (TPP) for pediatric TB.

Assessment of Factors Associated With Anti-Tubercular Treatment Compliance in Children: A Cross-Sectional Study.

Objective. This study aims to investigate compliance and the influencing factors related to pediatric tuberculosis patients who are undergoing treatment with anti-tuberculosis drugs in the Sichuan Province of China. Methods. A questionnaire survey was conducted between March 2019 and March 2021. The survey was distributed to caregivers of children aged 0 to 14 who had been diagnosed with pulmonary tuberculosis. These children had been receiving oral anti-tuberculosis drug treatment for more than 1 month. The survey was administered at the pediatric infection departments of West China Second University Hospital, Sichuan University, and The First People's Hospital of Ganzi Prefecture. Results. The study revealed a notable lack of medication adherence among the pediatric patients. Through multiple linear regression analysis, it was determined that several factors played a role in influencing medication adherence among children with tuberculosis. These factors include the educational level of the parents, the frequency of daily anti-tuberculosis drug prescriptions, and the parents' comprehension of the disease. All of these factors showed statistically significant influence on medication adherence among pediatric tuberculosis patients (all P < .05). Conclusion. In order to enhance adherence among pediatric patients undergoing anti-tuberculosis treatment, it is imperative to focus on reinforcing health education, particularly for parents with lower educational attainment and limited understanding of the disease.

Tuberculosis epidemic in India – a systematic review

Introduction and aim. India, accounting for approximately 26% of the global tuberculosis (TB) burden with a significant proportion of 0.11 million (6%) pediatric TB cases. The goal of this systematic review paper is to provide a thorough analysis of the TB epidemic in India, including information on the severity of the illness and challenges associated with diagnosis and treatment, the risk factors for transmission and progression of the disease, and the advancements and difficulties encountered in efforts to control at community level. Material and methods. The terms “Tuberculosis in India,” “Drug-Resistant Tuberculosis,” “Tuberculosis and Associated Co-morbidities,” “Diagnosis of Tuberculosis,” “Prevention of Tuberculosis,” and “Treatment of Tuberculosis’’, keywords were used to search in number of international electronic databases, including “Google Scholar,” “PubMed,” and “DOAJ.” Analysis of the literature. Diagnosis and treatment of TB are significantly complicated by co-morbid condition such includes alcoholism, diabetes, HIV, undernutrition, diabetes and HIV. In addition, there may be treatment delays, and the extra-pulmonary or drug-resistant TB due to ignorance, misunderstandings, and lack of education among TB patients, and medical professionals, which ultimately increases morbidity and mortality. Conclusion. Poverty, undernutrition, inadequate healthcare infrastructure, and co-morbidities, which frequently complicate TB diagnosis and treatment, must be addressed in addition to the critical need to prioritize TB research and development.

OVERVIEW OF CHEST RADIOGRAPH AND CLINICAL SYMPTOMS OF PEDIATRIC PULMONARY TUBERCULOSIS PATIENT IN PROF. DR. I.G.N.G NGOERAH HOSPITAL JANUARY 2021 – JUNE 2022

Tuberculosis (TB) is an infectious disease whose incidence is still quite high in Indonesia. The increasing incidence of pediatric pulmonary TB is still happening today. The diagnosis of pediatric pulmonary TB is still a hot topic because the chest radiograph and clinical symptoms are not typical and are often found in other diseases. The aim of the research is to know the overview of chest radiograph and clinical symptoms of pediatric pulmonary TB patients. This research was conducted at Prof. RSUP. Dr. I.G.N.G Ngoerah January 2021 – June 2022 using a cross-sectional descriptive method and medical record data as source with total sample is 30 people. Univariate analysis was performed using the Statistical Package for the Social Science (SPSS) version 26.0 for MacOS. The results of the study are majority of pediatric pulmonary TB patients at RSUP Prof. Dr. I.G.N.G Ngoerah January 2021 – June 2022 is female (60%), age group 11-16 years (50%), abnormal chest radiograph (96.7%), asymptomatic (63.3%), lymphadenopathy of hilar/paratracheal lymph nodes with/without parenchymal consolidation (96.7%), cough symptoms (30%). Children with pulmonary TB at RSUP Prof. Dr. I.G.N.G Ngoerah January 2021 – June 2022 is dominated by female gender, age group 11-16 years, abnormal chest radiograph, asymptomatic, lymphadenopathy of hilar/paratracheal lymph nodes with/without parenchymal consolidation and symptoms of cough.