Tüberkülozlu Çocuk Olguların Değerlendirilmesi: 10 Yıllık Retrospektif Çalışma
PDF
Cite
Share
Request
Original Article
P: 249-257
December 2022

Tüberkülozlu Çocuk Olguların Değerlendirilmesi: 10 Yıllık Retrospektif Çalışma

J Curr Pediatr 2022;20(3):249-257
1. Mersin Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Enfeksiyon Hastalıkları Bilim Dalı, Mersin, Türkiye
2. Uludağ Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Bursa, Türkiye
3. Uludağ Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Enfeksiyon Hastalıkları Bilim Dalı, Bursa, Türkiye
4. Dörtçelik Çocuk Hastanesi, Çocuk Enfeksiyon Hastalıkları Kliniği, Bursa, Türkiye
No information available.
No information available
Received Date: 01.04.2022
Accepted Date: 17.07.2022
Publish Date: 19.12.2022
PDF
Cite
Share
Request

ABSTRACT

Introduction:

Childhood tuberculosis is a perspective that adult tuberculosis is not well controlled in the community. In this study, it was aimed to evaluate the epidemiological and clinical data of the cases we followed up with the diagnosis of tuberculosis.

Materials and Methods:

The clinical data of the cases who admitted to the Pediatric Infection Clinic and Outpatient Clinic of our hospital between 2010 and 2020 and were diagnosed with tuberculosis were retrospectively analyzed. Approval for the study was obtained from the Ethics Committee of Uludag University Medical Faculty with the decision no. 2020-5/3.

Results:

The mean age of 175 cases was 125±66,038 (median 132, 3-216) months, and 51% were female. 88% of the cases (n=154) live in Bursa and the majority of the admissions are from Osmangazi (n=41, 23.4%), Yıldırım (n=40, 22.9%), İnegöl (n=20, 11.5%) and Nilüfer (n=19, 10.9%). Pulmonary tuberculosis was seen in 55% (n=96) of the cases, extrapulmonary tuberculosis in 42% (n=74), and pulmonary and extrapulmonary tuberculosis in 3% (n=5). 25.7% (n=45) of all cases had a history of contact with tuberculosis. 6.3% (n=11) of the cases had a history of taking prophylaxis before. Cough in 46% (n=81) of cases, fever in 29% (n=50), weight loss in 14% (n=24), night sweats in 13% (n=22), 5% (n=8) had complaints of hemoptysis. The mean sedimentation value of the cases was 36±28.85 (median 27. 5-140) mm/hour, and the mean CRP value was 16±41.94 (median 1. 1-258) mg/L. The tuberculin skin test was positive in 65% (n=114) of the cases. Mycobacter ARB (acid-resistant bacillus) was positive in 19% (n=27) and culture was positive in 18% (n=25) of the cases evaluated microbiologically (n=142). PCR was positive in 45% (n=47) of the 104 cases in which mycobacterial PCR was examined. Side effects were observed in 11% of the cases, and hepatotoxicity was observed most frequently (n=11, 6.3%). One patient died in the seventh month of treatment due to complications related to cystic fibrosis.

Conclusion:

Tuberculosis is a highly contagious disease caused by Mycobacterium tuberculosis and may result in mortality if left untreated. In this study, culture positivity was found to be 18%, and the most common side effect was hepatotoxicity.

References

1Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, et al. Global Tuberculosis Report 2020 - reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis 2021;113:7-12.
2Marais BJ, Gie RP, Schaaf HS, Hesseling AC, Obihara CC, Nelson LJ, et al. The clinical epidemiology of childhood pulmonary tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 2004;8:278-85.
3T.C Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Tüberküloz Tanı ve Tedavi Rehberi, Ankara 2019.
4T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Tüberküloz Dairesi Başkanlığı. Tüberküloz İstatistikleri. Erişim Tarihi: 2 Ekim 2021. Erişim Adresi: https://hsgm.saglik.gov.tr/tr/tuberkuloz-istatistikler
5Ildirim I, Hacimustafaogu M, Ediz Bü. Correlation of tuberculin induration with the number of bacillus calmette-guérin vaccines. Pediatr Infect Dis J 1995;14.
6WHO. Global tuberculosis report 2019. World Health Organization. 2020. Available from: https://www.who.int/publications/i/item/9789241565714
7Cruz AT, Starke JR. Clinical manifestations of tuberculosis in children. Paediatr Respir Rev 2007;8:107-17.
8Perez-Velez CM, Marais BJ. Tuberculosis in children. N Engl J Med 2012;367:348-61.
9Dilen MF, Çelik T, Tolunay O, Çelik Ü. Kliniğimizde takipli çocukluk çağı tüberkülozlarında klinik özellikler. J Pediatr Infect 2018;12:129-34.
10Aygün D, Yıldırım T, Başoğlu Öner Ö, Şiraneci R. Evaluation of clinical and laboratory characteristics of childhood tuberculosis. Turk Pediatri Ars 2020;55:236-43.
11World Health Organization Geneva. Guidance for National Tuberculosis Programmes on the management of tuberculosis in children. 2nd edition. WHO Press. 2014. Available from: https://apps.who.int/iris/bitstream/handle/10665/112360/9789241548748_eng.pdf
12Drobac PC, Shin SS, Huamani P, Atwood S, Furin J, Franke MF, et al. Risk factors for in-hospital mortality among children with tuberculosis: the 25-year experience in Peru. Pediatrics 2012;130:373-9.
13Kimberlin D, Barnett E, Lynfield R, Sawyer M, editors. Red Book: 2021-2024 Report of the Committee on Infectious Diseases By: Committee on Infectious Diseases, American Academy of Pediatrics, Itasca, IL 2021. In: American Academy of Pediatrics Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. Itasca, IL; 2021.
14Hatherill M, Hawkridge T, Zar HJ, Whitelaw A, Tameris M, Workman L, et al. Induced sputum or gastric lavage for community- based diagnosis of childhood pulmonary tuberculosis? Arch Dis Child 2009;94:195-20.
15Steiner P, Rao M, Victoria MS, Jabbar H, Steiner M. Persistently negative tuberculin reactions: their presence among children with culture positive for mycobacterium tuberculosis (tuberculin-negative tuberculosis). Am J Dis Child 1980;134:747-50.
16Van Den Bos F, Terken M, Ypma L, Kimpen JLL, Nel ED, Schaaf HS, et al. Tuberculous meningitis and miliary tuberculosis in young children. Trop Med Int Heal 2004;9: 309-13.
17Siqueira AM, Alencar AC, Melo GC, Magalhaes BL, Machado K, Alencar Filho AC, et al. Fixed-Dose Artesunate-Amodiaquine Combination vs Chloroquine for Treatment of Uncomplicated Blood Stage P. vivax Infection in the Brazilian Amazon: An Open-Label Randomized, Controlled Trial. Clin Infect Dis 2017;64:166-74. Erratum in: Clin Infect Dis 2017;64:1468.
18Pereira L. Tuberculosis: role of etiologic diagnosis and tuberculin skin test. Pediatr Pulmonol 2004;26:240-2.
19Starke JR. Pediatric tuberculosis: time for a new approach. Tuberculosis (Edinb). 2003;83:208-12.
20Starke JR. Mycobacteria tuberculosis. In: Rudolph A, Lister G, First L, Gershon A, (eds). Rudolph Pediatri. 22nd ed. 2013. p.1049-57.
21Nicol MP, Workman L, Isaacs W, Munro J, Black F, Eley B, et al. Accuracy of the Xpert MTB/RIF test for the diagnosis of pulmonary tuberculosis in children admitted to hospital in Cape Town, South Africa: a descriptive study. Lancet Infect Dis. 2011;11:819-24.
22Demir T, Çelik E, Antmen E. Çocuk tüberkülozu olgularının retrospektif olarak incelenmesi. Solunum Hast 1999;10:384-91.
23Göçmen A, Cengizler R, Özçelik U, Kiper N, Şenuyar R. Childhood tuberculosis: a report of 2205 cases. Turk J Pediatr 1997;39:149-58.
24Kurt A, Poyrazoğlu G, Turgut M, Akarsu S, Kurt AN, Aydın M, et al. Tüberküloz tanısı ile izlenen hastaların klinik ve laboratuar özellikleri. Fırat Tıp Derg 2006;11:55-7.
25Özkütük N, Sürücüoğlu S, Sezgin C, Özbakkaloğlu B: Celal Bayar Üniversitesi Tıp Fakültesi Mikobakteriyoloji Laboratuvarı verilerinin değerlendirilmesi. X Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi, 2001, s.15-9.
26Yağcı A, İlki A, Söyletir G. Marmara Üniversitesi Hastanesi Mikobakteriyoloji Laboratuvar Verileri. XXIX Türk Mikrobiyoloji Kongresi Kitabı. Antalya. 8-13 Ekim. p.355.
27Pamukçu Uyan A. Çocukluk çağı tüberkülozunda tanı sorunları. Güncel Pediatr 2008;6:26-30.
28Singh M, Ahsan Moosa NV, Kumar L, Sharma M. Role of gastric lavage and broncho-alveolar lavage in the bacteriological diagnosis of childhood pulmonary tuberculosis. Indian Pediatr 2000;37:947-51.
29Dodd PJ, Sismanidis C, Seddon JA. Global burden of drug-resistant tuberculosis in children: a mathematical modelling study. Lancet Infect Dis 2016;16:1193-201.
30T.C. Sağlık Bakanlığı. Türkiye’de Verem Savaş 2019 Raporu. Ankara 2020. Erişim adresi: https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/raporlar/Tu_rkiye_de_Verem_Savas_2019_Raporu_son_1.pdf
31Reis G, Bedran M, Moura J, Irmgard A, Rodriguez M. Six-month Isoniazid-Rifampin treatment for pulmonary tuberculosis in children. Am Rev Respir Dis 1990;142:996-9.
32Kaba Ö, Kara M, Odacılar CA, Kamer İ, Sütçü M, Demir SÖ, et al. Evaluation of cases of pediatric extrapulmonary tuberculosis: a single center experience. Turk Pediatr Ars 2019;54:86-92.
Article is only available in PDF format. Show PDF
2024 ©️ Galenos Publishing House