Clinical Profile of Pediatric Extrapulmonary Tuberculosis in a Tertiary Hospital: A 10-year Retrospective Study

Abstract

Background: Young children are at increased risk of developing severe forms of tuberculosis (TB) disease. Extrapulmonary tuberculosis (EPTB) contributes significantly to TB-related morbidities. This study aimed to determine patients’ epidemiologic and clinical profile with EPTB among children aged 0-18 years old admitted and diagnosed from January 2010 to December 2019 at Southern Philippines Medical Center (SPMC).Methodology: This is a retrospective cross-sectional study. The child’s medical records for EPTB admission in SPMC were retrieved. Data including demographic, clinical presentation, treatment outcomes and survival rate were recorded and subsequently analyzed.Results: There were 136 EPTB cases from January 2010 to December 2019. Prevalence of EPTB is 17% among all pediatric TB admissions. A total of 75 EPTB patients were evaluated. The average age of patients is 9 years old. Majority of patients belong to the 11-18yo. No significant difference among male and female patients. Most of the patients were malnourished, received BCG vaccine and had TB exposure to an infected family member. The most common symptoms were fever, seizure, vomiting, and headache. Majority of cases involved the central nervous system (CNS), followed by gastrointestinal involvement and the pleura. Half of the cases completed treatment and only two cases were cured. The average survival time based on Kaplan Meier Curve survival analysis is 34 days. Survival is below 80% on the 25^th hospital day and onwards.Conclusion: Extrapulmonary tuberculosis in children results in higher morbidity, mortality, and healthcare cost due to prolonged hospitalization and longer duration of treatment. Early diagnosis, intervention and treatment are the cornerstone in decreasing the burden of disease.

Keywords: Extrapulmonary, tuberculosis, extrapulmonary tuberculosis, central nervous system

DOI: 10.7176/JHMN/106-03

Publication date:March 31^st 2023