Profile and outcome of childhood tuberculosis treated with DOTS--an observational study.

OBJECTIVES

To study the clinical profile and outcome of childhood tuberculosis treated with Directly Observed Treatment Short (DOTS) course regimen. Also to study the side effects of anti-tubercular treatment (ATT).

METHODS

This prospective hospital based observational study was conducted at Department of Pediatrics, Karnataka Institute of Medical Sciences (KIMS), Hubli. Inclusion criteria were i) All newly diagnosed cases of tuberculosis from 0 to 12 y of age. ii) Children with relapse, treatment failure or defaulters. Exclusion criteria was children with tuberculosis on anti-tubercular treatment (ATT) other than DOTS regimen. A detailed history including demographic profile and clinical examination were carried out for each case. Diagnosis, categorization, treatment (DOTS regimen) and outcome measures were defined according to WHO/RNTCP guidelines. Data was analyzed using SPSS 17.

RESULTS

Total number of children enrolled in the study were 93. Mean age was 6 y. Male to female ratio was 0.9:1. Extra pulmonary tuberculosis (EPTB) was common 58 (62.4 %) than pulmonary tuberculosis 35 (37.6 %). The common symptoms/signs were fever (83.8 %), cough (46.2 %), convulsion (17.2 %), loss of appetite (11.8 %) and pallor (75.3 %), lymphadenopathy (18.3 %), hepatomegaly (9.7 %) and splenomegaly (6.5 %). Mantoux test was positive in 59 (63.4 %) children. Acid fast bacilli (AFB) was isolated in 13 (14 %) children in various fluid/histological specimens. The prevalence of HIV infection was 7.5 %. Among 93 children, 88(94.6 %) completed treatment and were declared cured; four children were lost to follow up and one child died. Compliance of DOTS was good and there were no side effects due to ATT.

CONCLUSIONS

EPTB was common than pulmonary TB. Efficacy of DOTS in index study was 94.6 %. No adverse effects of ATT were observed.