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Dr. Bipul Kumar Das (PGT)
Dr. Kumud Pathak, M.D.
Dr. P. Biswanath,Asso. Professor, Dept. of Paediatrics AMCH
A Clinical Study of Tuberculosis in Children with special reference to
Gastric Aspirate
Introduction
Tuberculosis - one of the most common diseases in the world with different names.
Diagnosis difficult in children.
1.5 Million New Cases every year.
130,000 Deaths Each Year.
Different Diagnostic Modalities –
- Clinical Signs & symptoms
- Mantoux Test
- Chest X-Ray
- BAL & Gastric Aspirate for AFB smear
- Culture Techniques
- Serodiagnosis
- Polymerase Chain Reaction
Gastric Aspirate Study for direct smear for AFB and culture is a valuable test for the diagnosis of Tuberculosis in Children
Aims and Objectives
Clinical study of Tuberculosis in Hospitalized children from age 1 – 12 years.
To see the positivity of Gastric Aspirate for AFB in Tuberculosis.
Inclusion Criteria
Provisionally diagnosed cases of Tuberculosis in Age Group of 1 -12 Years (as per WHO
guidelines).
Cases which were diagnosed with Pulmonary or Disseminated Tuberculosis.
Children below 1 year
Children above 12 Year
Exclusion Criteria
Materials & Methods
Study Centre – Department of Paediatrics, AMCH
Morning sample Gastric Aspirate of Probable cases of Pulmonary & Disseminated Tuberculosis.
Sample collection for 3 consecutive days..
Smear Examination by Ziehl Neelsen staining method.
Statistical Analysis – Student ‘t’ test.
Results&
Observations
Age group in Years
34.62%
17.94%
26.92%
20.52%
58.97% 41.03%
Perc
enta
ges
Nutritional Grade
20.51% 17.94%
16.66%
24.35%
20.51%
Normal Grade I Grade II Grade III Grade IV
6.41% 5.12%
19.23%
44.87%
24.35%
Socioeconomic Status
Perc
enta
ges (
%)
51.28% 37.17%
11.53%
80.77%
19.23%
48.71%
51.28%
Mantoux Reactivity with Nutritional Status
Nutritional Status
Perc
enta
ges
72.00% 28.00%
28.88%71.12%
47.05%
23.07%16.67%
12.50%
Age Group (in years)
Perc
enta
ge (%
)
28.57% 27.27%
Perc
enta
ge (%
)
SEX
Author with Year
Age Group Total No. of Cases
No. of AFB Positive cases
% of Positive cases
Abadco et al
(1992)Mean Age 2.5
Years20 10 50.00
Somu et al (1995)
7 months to 2 years
50 16 32.00
Pomputius et al (1997)
Not Mentioned
8 4 50.00
Lobato et al (1998)
< 2 Years 80 33 41.00
Singh et al (2000)
6 months to 14 Years
58 10 17.20
Gomez et al (2000)
Not Mentioned
46 15 32.60
Guillermo et al (2001)
Mean Age 6.8 Years
135 50 37.00
Zar et al (2006)
1 Month to 5 Years
250 40 16.00
Present Study (2006)
1- 12 Years 45 13 28.89
Conclusion
Tuberculosis more common in < 6 years of age.
Poor socioeconomic status and malnutrition have Definite relation.
Mantoux test is Positive in almost half of the patients.
AFB positive in 28.89% children with Pulmonary Tuberculosis in Gastric Aspirate.
Gastric Aspirate for isolation of Tubercle Bacilli
should be tried in every case as far as possible, as
demonstration of AFB is the Gold Standard for
diagnosis of Tuberculosis.
Recommended