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. 2022 Aug 1;41(8):620-625.
doi: 10.1097/INF.0000000000003584. Epub 2022 Jul 13.

Age-specific Clinical Presentation and Risk Factors for Extrapulmonary Tuberculosis Disease in Children

Melanie M Dubois  1   2 , Meredith B Brooks  2 , Amyn A Malik  3   4 , Sara Siddiqui  5 , Junaid F Ahmed  5 , Maria Jaswal  5 , Farhana Amanullah  5 , Mercedes C Becerra  2 , Hamidah Hussain  4
Affiliations

Age-specific Clinical Presentation and Risk Factors for Extrapulmonary Tuberculosis Disease in Children

Melanie M Dubois et al. Pediatr Infect Dis J. .

Abstract

Background: Clinical presentation for extrapulmonary tuberculosis (EPTB) in children can be variable and nonspecific, leading to delayed diagnosis, disease and death. We describe the age-specific clinical presentation and identify risk factors for EPTB among children in Pakistan.

Methods: In 2015-2016 in 4 facilities in Sindh, Pakistan, children were diagnosed with TB either through bacteriologic confirmation or clinical-radiologic criteria. EPTB comprised any form of TB disease that did not involve the lungs. Among children with TB disease, we report demographics, clinical characteristics and symptoms, family medical history and diagnostic test results for children with and without EPTB. We conduct age-specific regression analyses to identify factors associated with an EPTB diagnosis among children age 0-4, 5-9 and 10-14 years.

Results: A total of 1163 children were diagnosed with TB disease, of which 157 (13.5%) had EPTB. Of those, 46 (29.3%) were 0-4, 53 (33.8%) were 5-9 and 58 (36.9%) were 10-14 years old. Of children with EPTB, the most frequently reported sites were lymph node (113, 72.4%) and abdominal (31, 19.9%). Weight loss was associated with an increased risk of EPTB in the 0-4-year-old (adjusted odds ratio: 2.80, 95% confidence interval: 1.05-7.47) and 10-14-year-old (adjusted odds ratio: 2.79, 95% confidence interval: 1.28-6.07) groups, and the presence of cough was associated with a decreased risk of EPTB.

Conclusions: This study provides new knowledge about age-specific clinical presentation and risk factors of EPTB in children in Pakistan. Our results can help to optimize clinical algorithms designed to achieve a timely diagnosis in children with EPTB along with improved treatment outcomes.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
Age-specific percentages of site of EPTB disease in children (n = 156).
See this image and copyright information in PMC

References

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