The Evaluation of Clinical Profile and Mortality of Children Admitted with Tuberculosis in Pediatric Intensive-Care Unit at Sassoon General Hospitals, Pune

Post Date: 
2016-10-27
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Summary: 
Tuberculosis (TB) is one of the most common causes of infection-related death globally. TB was declared global public health emergency in 1993 by World HealthOrganization (WHO).  Mortality due to TB is increasing due to emergence of multidrug resistant (MDR) strains and HIV-TB co-infection, increasing number of homeless and malnourished individuals. Other factors responsible for it include overcrowded areas, immunosuppressive states like extremes of age, malnutrition, administration of chemotherapy and prolonged steroid use. Fatal and serious complications in the form of tuberculous meningitis (TBM) and miliary TB affects mostly children and more so infants. Of all the cases, only a few are being detected and even fewer of these complete the prescribed course of treatment.  Globally, more than 9 million new cases of TB occur each year,  according  to  WHO  and 10%  of  all  the  TB  cases  is  found  amongst children. India  comes  under  a  group  of  high  prevalence  countries according to review by WHO.  About 2 million new cases of TB occur each year and 38% of all the TB cases is found among children . Children are at a higher risk of developing disease from adults, hence it would be right to say that adult tuberculosis is the fountainhead of pediatric tuberculosis.
 
The precise estimates of the magnitude of TB disease in children are difficult to obtain. Very little information can be drawn from hospital records since symptoms of the disease are neither specific nor pressing enough to seek relief. More often, diagnosis of TB among children is made on an empirical basis without objectivity. Objective diagnosis should be based on several criteria like history, clinical examination, investigations like tuberculin test, chest X-ray and histopathological examination. Since obtaining sputum specimens from children is difficult, bacteriological confirmation is very infrequent.
 
There is overall scarcity of information on TB in pediatric age group.  Proper identification and treatment of infectious cases will prevent childhood TB and its further complications.
 
Aim:
To review the clinical profile and outcome of children with pulmonary tuberculosis (TB) and extra-pulmonary tuberculosis admitted to a Pediatric Intensive Care Unit (PICU) in a Tertiary Care Hospital.