PREVALENCE OF PULMONARY TUBERCULOSIS IN SEVERE ACUTE MALNOURISHED CHILDREN WITH ACUTE PNEUMONIA
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Keywords
SAM, Xpert MTB/RIF Assay, Pneumonia, and Tuberculosis
Abstract
Background: The most severe type of malnutrition that affects children under five is called severe acute malnutrition (SAM), and it is linked to a number of infectious illnesses, including tuberculosis (TB). Although it is crucial for managing pneumonia in children residing in areas where tuberculosis is extremely common, the presentation of pulmonary tuberculosis (PTB) as pneumonia in severely malnourished children has not received much attention.
Objective: To investigate the prevalence of acute pneumonia and severe acute malnutrition in children with pulmonary tuberculosis.
Materials And Methods: Prospective hospital based observational study done in children admitted to NRC, Pediatric Department, Hubballi from January 2015 to December 2015 with diagnosis of severe acute malnutrition with pneumonia.
Results: A total of 29 children were enrolled in the study; their male to female ratio was 0.9:1, and their mean age was 14.29±9.63 months. 10.34% (3/29) of SAM patients with acute pneumonia had pulmonary tuberculosis. Two of the three cases involved younger than twelve months old, and they were all male. Clinical symptoms/signs in order of frequency were fever (100%), respiratory distress (100%), and cough (66.66%). Possession of a contact history (66.66% (2/3) and a positive Mantoux test (66.66% (2/3) were risk factors for TB development. Though tuberculosis was greater in children with absence BCG scar yet it was statistically not significant (2/3). While the smear for AFB was positive in only one child, the Xpert MTB/RIF assay was positive in all three cases. In our investigation, the Mantoux test's sensitivity and specificity for TB diagnosis were 66.6% and 96%, respectively.
Conclusion: Consideration should be given to pulmonary tuberculosis in children who have pneumonia and severe acute malnutrition. When it came to isolating TB bacilli, Xpert MTB/RIF was found to be more effective than smear for AFB.
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Dr. Shruthi Siddalingappa
Assistant Professor, Department of Pediatrics, Subbaiah Institute of Medical Sciences, Shimoga, Karnataka, India.
Dr. Vinodh Ratgeri
Professor, Department of Pediatrics, Karnataka Institute of Medical Sciences (KIMS), Hubballi, Karnataka, India.
Dr. Vijaya Suryakiran K.M.
Assistant Professor, Department of Pediatrics, Subbaiah Institute of Medical Sciences, Shimoga, Karnataka, India.
Dr. Talavara Mahendra
Consultant Physician, Sai Multispeciality Hospital, Hoovinahadagali, Karnataka, India.