Proportion and Factors Associated with Presumptive Tuberculosis among Suspected Pediatric TB Patients

Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

Abstract:

The study addresses the increasing challenge of pediatric presumptive tuberculosis, emphasizing the need to understand the factors associated with it. The research aims to determine the proportion of presumptive TB and factors associated with it among suspected pediatric tuberculosis patients. A cross-sectional study was conducted at ICDDR-Bangladesh, collecting specimens from suspected pediatric patients and using logistic regression for data analysis. The study found a high proportion of presumptive TB (85.7%) but no statistically significant differences between presumptive and non-presumptive TB. Theoretical importance of the study highlights the importance of identifying factors associated with presumptive TB for better control and management strategies. Specimens were collected from 84 suspected pediatric patients diagnosed with TB based on clinical symptoms/radiological findings. Microbiological tests like smear-microscopy, culture, and GeneXpert were used to isolate presumptive TB and confirmed TB. The proportion of presumptive TB was 85.7% among suspected pediatric TB patients. Among various factors that were not found to be associated with the presumptive TB. The study concludes that despite a high proportion of presumptive TB, no significant differences were found between presumptive and non-presumptive TB cases.

Keywords: Presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis.

References:

[1] Nur N., Sharif A. B. and Mitra D. K. (2023). Stress resilience in patients with drug-resistant TB. The International Journal of Tuberculosis and Lung Disease 27(7):551-556. https://doi.org/10.5588/ijtld.22.0648
[2] Talukder K., Salim M. A. H., Jerin I., et al. (2012) Intervention to increase detection of childhood tuberculosis in Bangladesh. Int J Tuberc Lung Dis. 16(1):70–75; 16(January 2011): 70–75. http://dx.doi.org/10.5588/ijtld.11.0060.
[3] Hailu D., Abegaz W. E., Belay M. (2014) Childhood tuberculosis and its treatment outcomes in Addis Ababa: a 5-year retrospective study. BMC Pediatr; 14(61). http://www.biomedcentral.com/1471-2431/14/61.
[4] Islam Z., Sanin K. I., Ahmed T. (2017). Improving case detection of tuberculosis among children in Bangladesh: lessons learned through an implementation. BMC Public Health 17(131); 1-9. https://doi.org/10.1186/s12889-017-4062-9
[5] Sanchini, A., Fiebig, L., Drobniewski. F. et al. (2014). Laboratory diagnosis of paediatric tuberculosis in the European Union/European Economic Area: analysis of routine laboratory data, 2007 to 2011. Euro Surveill. 2014;19(11). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId = 20744.
[6] Chisti M. J., Graham S. M., Duke T. et al. (2014). A Prospective Study of the Prevalence of Tuberculosis and Bacteraemia in Bangladeshi Children with Severe Malnutrition and Pneumonia Including an Evaluation of Xpert MTB/RIF Assay. PLoS One; 9(4): e93776. http://doi: 10.1371/journal.pone.0093776.
[7] Wobudeya E., Bonnet M., Walters E. G., et al. (2022). Diagnostic Advances in Childhood Tuberculosis-Improving Specimen Collection and Yield of Microbiological Diagnosis for Intrathoracic Tuberculosis. Pathogens; 11(4): 389. https://doi.org/10.3390/pathogens11040389.
[8] Zar. H. J., Hanslo. D., Apolles. P., et al. (2005). Induced sputum versus gastric lavage for microbiological confirmation of pulmonary tuberculosis in infants and young children: a prospective study. Lancet; 365: 130–34.
[9] Sharma S. K., Kohli M., Yadav R. N., et al. (2015). Evaluating the diagnostic accuracy of xpert MTB/RIF assay in pulmonary tuberculosis. PLoS One; 10(10): 1-9. https://doi.org/10.1371/journal.pone.0141011
[10] World Health Organization (WHO) (2014). Xpert MTB_RIF implementation manual_ technical and operational ‘how-to’; practical considerations. https://www.ncbi.nlm.nih.gov/books/NBK254323/
[11] Kamruzzaman M., Hossain M., Islam A., et al. (2019). Clinical Profile of Tuberculosis: A Study in a Tertiary Care Paediatric Hospital, Dhaka, Bangladesh. Journal of Dental and Medical Sciences; 18(5): 34-39. https://doi.org/10.9790/0853-1805143439
[12] Shruthi S., Ratageri V. H., Shivananda I., et al. (2019). Pulmonary Tuberculosis in Children with Severe Acute Malnutrition: A Prospective Hospital-based Study. Pediatric Infectious Disease; 1(1): 1-3. https://doi.org/10.5005/jp-journals-10081-1101
[13] Haque M., Supti S. H., Jahan et al. (2023). Clinico-Epidemiological Profile and Diagnostic Procedures of Tuberculosis in Children: A Retrospective Study from OPD of Tertiary Care Center in Bangladesh. Journal of Tuberculosis Research; 11(1): 1-11. https://doi.org/10.4236/jtr.2023.111001
[14] Petroff S. A. (1915). A new and rapid method for isolation and culture of tubercle bacilli directly from the sputum and faece. J Exp Med; 21 (1): 38-42. https://doi.org/10.1084/jem.21.1.38.
[15] Ahsan M. R., Hussain M., Makbul S., et al. (2019). Clinical Pattern of Pediatric Tuberculosis in a Tertiary Care Hospital in Bangladesh. Dhaka Shishu (Children). Hospital Journal; 35(1): 9-13.
[16] Guo Q., Pan Y., Yang Z., et al. (2016). Epidemiology and clinical characteristics of pediatric drug-resistant tuberculosis in chongqing, China. PLoS One; 11(3): 1-12. https://doi.org/10.1371/journal.pone.0151303
[17] Satana D., Genc G. E., Tamay Z. et al. (2014). Prevalence and drug resistance of mycobacteria in Turkish cystic fibrosis patients. Annals of Clinical Microbiology and Antimicrobials; 13:28. http://www.ann-clinmicrob.com/content/13/1/28.
[18] Kabir S., Uddin M. K. M., Chisti M. J., et al. (2018). Role of PCR method using IS6110 primer in detecting Mycobacterium tuberculosis among the clinically diagnosed childhood tuberculosis patients at an urban hospital in Dhaka, Bangladesh. Int J Infect Dis; 68: 108–114. https://doi.org/10.1016/j.ijid.2018.01.015.
[19] Alavi S. M., Salmanzadeh S., Bakhtiyariniya P., et al. (2015). Prevalence and treatment outcome of pulmonary and extra-pulmonary pediatric tuberculosis in southwestern Iran. Casp J Intern Med; 6(4): 213-219. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649270/pdf/cjim-6-213.pdf.
[20] World Health Organization (WHO) (2022). Global Tuberculosis Control. Global TB Programme. Geneva, Switzerland. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022.