Tuberculous disease in a pediatric referral centre: 16 years experience.

Children with evidence of tuberculous disease registered at the TB Clinic, Institute of Child Health, Madras during the years 1977 to 1992 were analyzed. Progressive primary complex, is the commonest thoracic form of tuberculosis while tuberculous meningitis is the commonest extra thoracic form. The overall prevalence of various clinical forms of tuberculosis has decreased over the last 16 years. There is an increasing trend in the prevalence of progressive primary complex among the BCG vaccinated group. The prevalence of pleural effusion, bone tuberculosis and abdominal tuberculosis is almost same over the last 16 years and is more in the BCG non vaccinated children. In tuberculous adenitis there is no significant variation between the two groups. The occurrence of tuberculous meningitis is in the ratio of 1:3 among BCG vaccinated and non-BCG vaccinated children. Though the prevalence of miliary tuberculosis is negligible, it is significantly more in BCG non-vaccinated children. There is a tendency for slight decrease in overall mortality due to tuberculosis in the last 10 years but the mortality due to tuberculous meningitis continues to be the same over the past 16 years.