The pattern of pediatric tuberculosis and treatment outcomes from 2012 to 2016 in Erbil City, Iraq
DOI:
https://doi.org/10.15218/zjms.2020.033Keywords:
Mycobacterium, Tuberculosis, Pediatric, Treatment, OutcomeAbstract
Background and objective: M. tuberculosis is one of the main causes of morbidity and mortality in many countries and is considered a priority global health problem. Although it is a curable disease, every year about nine million people develop active disease, and two million die from it. This study aimed to find the pattern of tuberculosis among children in Erbil city and determine the treatment outcomes of pediatric tuberculosis.
Methods: From March 2012 to March 2016, 142 patients younger than 18 years with confirmed diagnosis of tuberculosis were registered and treated at the Chest and Respiratory Disease Centre in Erbil. The diagnosis of tuberculosis was performed based on routine tests at the center. AFB smear staining, GeneXpert assay, and culture methods when required for further confirmations using L-J media.
Results: The total number of the studied records of tuberculosis was 729 during five years (2012-2016). More than half (55.6%) of patients aged ≤ 18 years were males. It is evident that the number of cases is increasing with the progress of years, but the difference was not significant between the years (P = 0.534). The death rate was 9.1% among patients of the whole sample, but no significant association was detected between age and outcome and was highest (22.7%) among patients aged 7-12 years (P = 0.142).
Conclusion: Tuberculosis is still a very severe disease with high mortality rates in children. Early recognition of infection associated with correct early treatment, systematic entourage investigation, and chemoprophylaxis by isoniazide in all children under five years of age is essential for attempting to reduce these prognostic indices.
Metrics
References
Phongsamart W, Kitai I, Gardam M, Wang J, Khan K. A population-based study of tuberculosis in children and adolescents in Ontario. Pediatr Infect Dis J 2009; 28(5):416–9.
Swaminathan S, Rekha B. Pediatric tuberculosis: global overview and challenges. Clin Infect Dis 2010; 50(Suppl 3):S184–94.
WHO. Global Tuberculaosis Report; 2016.
John TJ, Vashishtha VM, John SM. 50 years of tuberculosis control in India: progress, pitfalls and the way forward. Indian Pediatr 2013; 50:93–8.
Graham SM, Sismanidis C, Menzies HJ, Marais BJ, Detjen AK, Black RE. Importance of tuberculosis control to address child survival. The Lancet 2014; 383(9928):1605–7.
Perez-Velez CM, Marais BJ. Tuberculosis in children. N Engl J Med 2012; 367:348–61.
Seddon JA, Shingadia D. Epidemiology and disease burden of tuberculosis in children: a global perspective. Infect Drug Resist 2014; 7:153–65.
WHO. Treatment of Tuberculosis: Guidelines for National Programmes;2003.
Nelson LJ, Wells CD. Global epidemiology of childhood tuberculosis. Int J Tuberc Lung Dis 2004; 8:636–47.
Esposito S, Tagliabue C, Bosis S. Tuberculosis in Children. Mediterr J Hematol Infect Dis 2013; 5:e2013064.
Marias BJ, Hesseling AC, Gie RP, Scaaf HS, Beyers N. The burden of childhood tuberculosis and the accuracy of routine surveillance data in a high-burden setting. Int J Tuberc Lung Dis 2006; 10:259–63.
Joshi S. A study of treatment outcome of paediatric tuberculosis patients in an urban city of central India. Int J Community Med Public Health 2018; 5(4):1503–8.
Schaaf HS, Marais BJ. Management of multidrug-resistant tuberculosis in children: a survival guide for paediatricians. Paediatr Respir Rev 2010;12(1):31–8.
Bafwafwa DN, Mukuku O, Lukamba RM, Tshikamba EM, Kanteng GW, Mutombo AM, et al. Risk Factors Affecting Mortality in Children with Pulmonary Tuberculosis in Lubumbashi, Democratic Republic of the Congo. J Lung Pulm Respir Res 2017; 4(6):00151.
Alavi SM, Salmanzadeh S, Bakhtiyariniya P, Albagi A, Hemmatnia F, Alavi L. Prevalence and treatment outcome of pulmonary and extrapulmonarypediatric tuberculosis in southwestern Iran. Caspian J Inern Med 2015; 6(4):213.
Birungi FM, van Wyk B, Uwimana J, Ntaganira J, Graham SM. Xpert MTB/RIF assay did not improve diagnosis of pulmonary tuberculosis among child contacts in Rwanda. Pan Afr Med J 2018; 30:39.
Bolursaz MR, Lotfian F, Aghahosseini F, Hassanzad M, Ghafaripoor H, Khalilzadeh S, et al. Characteristics of Tuberculosis among Children and Adolescents at a Referral TB’s Hospital 2006-2011. J Compr Ped 2016; 7(3):e59822.
Kitai I, Morris SK, Kordy F, Lam R. Diagnosis and management of pediatric tuberculosis in Canada. CMAJ 2017; 189(1):E11–6.
Gosai DK, Gosai JB, Shukla OS. Study of clinical profile of childhood extra pulmonary tuberculosis. Int J Res Med Sci 2014; 2:501
Singh M, Mynak ML, Kumar L, Mathew JL, Jindal SK. Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis. Arch Dis Child 2005; 90(6):624–8.
Barros VN, Elisa MN, Luiza OA, Mariana B, Alan VF, Rodrigo D. Characterization of tuberculosis in children and adolescents in underdeveloped country. Hos Pal Med Int Jnl 2018; 2(4):246‒9.
Loh SW, Thoon KC, Tan NW, Li J, Chong CY. Paediatric tuberculosis in Singapore: a retrospective review. BMJ Paediatrics 2018; 2:e000308.
Carvalho AC, Cardoso CA, Martire TM, Migliori GB, Sant’Anna CC. Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy. J Bras Pneumol 2018; 44(2):134–44.
Schaaf HS, Michaelis IA, Richardson M, Booysen CN, Gie RP, Warren R, et al. Adult-to-child transmission of tuberculosis: household or community contact? Int J Tuberc Lung Dis 2003; 7(5):426–31.
Zar HJ, Hanslo D, Apolles P, Swingler G, Hussey G. Induced sputum versus gastric lavage for microbiological confirmation confirmation of pulmonary tuberculosis in infants and young children: a prospective study. Lancet 2005; 365:130–4.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Ahang Hasan Mawlood (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
