Presumptive Tuberculosis In Children Below 12 Years At Tertiary Care Rural Hospital
Abstract
Background: Tuberculosis remains a significant public health challenge, particularly affecting children in India with an estimated 2.2 lakh cases annually. The clinical presentation of tuberculosis in pediatric populations differs markedly from adults, presenting unique diagnostic challenges. This study aimed to investigate presumptive tuberculosis in children below 12 years at a tertiary care rural hospital following the NTEP 2020 protocol.
Objectives:
- To diagnose tuberculosis according to NTEP 2020 protocol
- To study the clinical profile and nutritional status of these patients
- To identify confirmed cases of tuberculosis from presumptive cases
Materials & Methods: We conducted an observational, descriptive cross-sectional study of 120 patients over two years (June 2022 - May 2024) at a tertiary care rural hospital. Children presenting with persistent fever or cough exceeding two weeks, significant weight loss, or contact history with pulmonary TB patients were enrolled. A standardized study proforma captured detailed clinical information. Comprehensive evaluation included anthropometric measurements, laboratory investigations, tuberculin testing, radiological assessment, and microbiological studies following NTEP 2020 guidelines.
Results: Among 120 children with presumptive tuberculosis, 75 (62.5%) were confirmed cases. The majority (86.66%) of confirmed cases occurred in children under five years. Males showed higher prevalence (65.33%) compared to females. Persistent cough was the predominant symptom (82.66%), followed by fever (57.33%). Severe acute malnutrition was present in 46.77% of confirmed cases aged 6 months to 5 years. Hilar lymphadenopathy was the most common radiological finding (76%). Mantoux test positivity was observed in 33.33% of confirmed cases. Pulmonary tuberculosis constituted 94.66% of confirmed cases, while 5.33% presented with extrapulmonary manifestations.
Conclusion: Implementation of the NTEP 2020 protocol demonstrates effectiveness in early tuberculosis detection among children. The strong association between malnutrition and tuberculosis emphasizes the need for systematic TB screening in malnourished children. The study supports a comprehensive diagnostic approach combining clinical, radiological, and microbiological criteria, particularly focusing on children under five years who represent the most vulnerable group.
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References
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