Profile and outcome of childhood tuberculosis treated with DOTS--an observational study

Abstract

Objectives: To study the clinical profile and outcome of childhood tuberculosis treated with Directly Observed Treatment Short (DOTS) course regimen. Also to study the side effects of anti-tubercular treatment (ATT).

Methods: This prospective hospital based observational study was conducted at Department of Pediatrics, Karnataka Institute of Medical Sciences (KIMS), Hubli. Inclusion criteria were i) All newly diagnosed cases of tuberculosis from 0 to 12 y of age. ii) Children with relapse, treatment failure or defaulters. Exclusion criteria was children with tuberculosis on anti-tubercular treatment (ATT) other than DOTS regimen. A detailed history including demographic profile and clinical examination were carried out for each case. Diagnosis, categorization, treatment (DOTS regimen) and outcome measures were defined according to WHO/RNTCP guidelines. Data was analyzed using SPSS 17.

Results: Total number of children enrolled in the study were 93. Mean age was 6 y. Male to female ratio was 0.9:1. Extra pulmonary tuberculosis (EPTB) was common 58 (62.4 %) than pulmonary tuberculosis 35 (37.6 %). The common symptoms/signs were fever (83.8 %), cough (46.2 %), convulsion (17.2 %), loss of appetite (11.8 %) and pallor (75.3 %), lymphadenopathy (18.3 %), hepatomegaly (9.7 %) and splenomegaly (6.5 %). Mantoux test was positive in 59 (63.4 %) children. Acid fast bacilli (AFB) was isolated in 13 (14 %) children in various fluid/histological specimens. The prevalence of HIV infection was 7.5 %. Among 93 children, 88(94.6 %) completed treatment and were declared cured; four children were lost to follow up and one child died. Compliance of DOTS was good and there were no side effects due to ATT.

Conclusions: EPTB was common than pulmonary TB. Efficacy of DOTS in index study was 94.6 %. No adverse effects of ATT were observed.