Clinical profile of paediatric extrapulmonary tuberculosis (EPTB) in a tertiary care hospital of Eastern India-  A prospective study.

Imman Kalyani  Jena; Sunil Kumar  Agarwalla

doi:10.51168/sjhrafrica.v6i6.1875

Authors

Imman Kalyani Jena Junior Resident, Department of Pediatrics, SCB MCH & SVPPGIP, Cuttack, Odisha, India
Sunil Kumar Agarwalla Sunil Kumar Agarwalla, Professor, Department of Pediatrics, SCBMCH & SVPPGIP, Cuttack, Odisha, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1875

Keywords:

Pediatric extrapulmonary tuberculosis, CNS TB, diagnosis, clinical profile, Odisha

Abstract

Background

Extrapulmonary tuberculosis (EPTB) in children remains a significant health challenge with diverse clinical presentations and diagnostic difficulties. Given the diagnostic complexity and potential severity of pediatric extrapulmonary TB, particularly in high-burden regions like India, it is crucial to better understand its clinical presentation and epidemiological profile.

Objectives: This study aimed to evaluate the clinical profile, diagnostic methods, and outcomes of pediatric EPTB cases admitted to a tertiary hospital in Odisha.

Methods

A prospective observational study was conducted over 21 months at SCB Medical College, enrolling 196 pediatric patients aged 1 month to 14 years diagnosed with EPTB. Data on demographics, clinical features, diagnostic approaches, and outcomes were collected using structured proformas. Diagnoses were confirmed based on national guidelines through clinical, radiological, microbiological, and histopathological methods. Statistical analysis was performed using SPSS v24 with significance set at p < 0.05.

Results

Most patients were aged 5–10 years (40.8%) with a male predominance (57.7%). CNS tuberculosis was the most common diagnosis (50.5%), especially among males (59.3%). Fever was the predominant symptom (84.7%), with seizures in 45.9% of cases. Neurological symptoms were also prominent, with seizures present in 45.9% and altered sensorium in 25% of the cases, reflecting central nervous system involvement. Respiratory symptoms such as cough and chest pain were reported in 25.5% and 16.8% respectively. The association between diagnosis and gender showed significant differences across various forms of EPTB, with a p-value of 0.000.

Conclusion

Pediatric EPTB presents with varied clinical and diagnostic profiles, necessitating age-tailored approaches for early detection and management.

Recommendations

As this was a short-term study, further research is needed with a longitudinal study design and a larger sample to achieve more definitive results.

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