Childhood Tuberculosis In A Community Hospital From A Region Of High Environmental Exposure In North India
Dr Pankaj Garg, B-342, Sarita Vihar, New Delhi. E-mail: email@example.com, firstname.lastname@example.org Ph: +91 9811062793.
Data on the spectrum of childhood tuberculosis at community hospitals in north India is lacking. We conducted a prospective observational study on children attending an outpatient department of a community level hospital in north India to determine the prevalence of tuberculosis in children, and highlight the spectrum of the disease at this level. All consecutive children attending out-patient department (January 15 to June 15, 2004), and diagnosed as probable or confirmed tuberculosis using World Health Organization (WHO) and Indian Academy of Pediatrics (IAP) guidelines were enrolled. The prevalence of tuberculosis, out of total attendances, was found to be 3.5% (95% CI 2.5%- 4.0%). Sixty-seven out of seventy-eight (86%) children were diagnosed to have highly probable tuberculosis while eleven (14%) cases were confirmed (bacteriological or histological) to harbor the disease. The prevalence of extra-pulmonary TB was very high (47.6%). Median duration of symptoms at the time of presentation was 4.5 months. Prevalence of tuberculosis in children at community level hospitals is high (3.5%). Spectrum of disease appears to be the same as that reported from the tertiary level institutions in north India, with almost half of the children presenting with extra-pulmonary tuberculosis, and long delays between onset of symptoms and eventual diagnosis. This highlights the need for strengthening of community hospitals, and more public awareness campaigns, especially in the vulnerable sections of society to control tuberculosis in this part of India.