Evaluation of diagnostic components and management of childhood pulmonary tuberculosis: a prospective study from Istanbul, Turkey

  • Aysegul Dogan Demir Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Arif Kut Division of Pediatric Pulmonology, Maltepe University, Istanbul, Turkey
  • Erhan Ozaydin Sureyyapasa Chest Diseases Training and Research Hospital, Istanbul, Turkey
  • Mustafa Nursoy Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Fatma Betul Cakir Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Feyza Ustabas Kahraman Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Ufuk Erenberk Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Selcuk Uzuner Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Abdulhamit Collak Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Zeynep Ebru Cakin Division of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
  • Erkan Cakir Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey
Keywords: tuberculosis, child, drug resistance

Abstract

Introduction: The diagnosis of childhood tuberculosis is difficult and most of the patients are diagnosed clinically. The objective of this study is to reveal the diagnostic and therapeutic components of childhood pulmonary tuberculosis and to analyze the changes that occurred in our country over the years.

Methodology: All patients diagnosed with tuberculosis between 2006 and 2016 were included. Demographic characteristics, diagnostic and treatment outcomes were recorded and patients were followed up prospectively.

Results: A total of 492 patients were included in the study. 97% had Bacillus Calmette-Guerin vaccine, 36% were diagnosed with microbiologically-confirmed tuberculosis and 64% were diagnosed with clinically-proven tuberculosis. 94% of the patients had symptoms consistent with tuberculosis, all patients had radiologic findings, 74% had a history of tuberculosis contact and 63% had tuberculin skin test positivity. The diagnoses included primary tuberculosis in 62%, secondary tuberculosis in 21%, progressive primary tuberculosis in 13% and miliary tuberculosis in 4%. 48% of the patients received a treatment regimen containing three drugs as the initial treatment, and drug-related side effects developed in 12%. Isoniazid resistance was detected in 13% of the patients and rifampicin resistance was detected in 8%. None of the patients died due to tuberculosis. In the last 50 years in Turkey, the rates of Bacillus Calmette-Guerin vaccination and diagnosis of tuberculosis cases have increased and the mortality rates have decreased over the years.

Conclusions: Our study is one of the few prospective studies and revealed the differences between the recent data and the past 50 years in childhood tuberculosis in Turkey.

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Published
2022-01-31
How to Cite
1.
Dogan DemirA, Kut A, OzaydinE, NursoyM, Cakir FB, Ustabas KahramanF, Erenberk U, Uzuner S, Collak A, Cakin ZE, Cakir E (2022) Evaluation of diagnostic components and management of childhood pulmonary tuberculosis: a prospective study from Istanbul, Turkey. J Infect Dev Ctries 16:112-119. doi: 10.3855/jidc.14505
Section
Original Articles