Clinical profile and treatment outcome of tuberculous lymphadenitis in children using DOTS strategy.
BACKGROUND
Extra pulmonary TB (EPTB) including tuberculous lymphadenitis is becoming more common probably due to human immuno deficiency virus (HIV) co-infection. While children do experience a high TB related morbidity and mortality, management of TB in children is challenging. The present study was designed to study the treatment outcome of DOTS strategy for pediatric tuberculous lymphadenitis.


OBJECTIVE
To study the efficacy of DOTS strategy for pediatric lymphhnode tuberculosis.


METHODS
Retrospective analysis of 669 children of lymphnode tuberculosis treated with DOTS strategy over 9 1/2 years.


RESULTS
Mean age was 9.8 years with significantly more girls (61.3%) than boys (38.7%) {chi2=34.08, P<0.001 (S)}. Most of the patients were in the age group of 11-14 years (48.0%) followed by 6-10 years (34.5%) and 0-5 years (17.5%) respectively. Cervical tuberculous lymphadenitis (88.2%) was the commonest form for all ages followed by axillary lymphadenitis in 3.3%. TB of other sites was seen in only 57 (8.5%) cases. Out of total 622 (93%) cases of lymphnode TB where fine needle aspiration and/or excisional biopsy was done, it was positive (84.2%) and negative (15.6%) respectively for AFB/cytology, while it could not be done in 47 patients due to inaccessible sites. Category I, II and III was started on 15.4%, 7.5% and 77.1% patients respectively. Overall, treatment completion rate was 94.9% and the default rate was 2.2% with a failure rate of 2.5%. Death rate was 0.3%.


CONCLUSIONS
The study confirms the efficacy of DOTS strategy for pediatric TB lymphadenitis.
Sharma
Sangeeta
S
LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi.
Sarin
Rohit
R
Khalid
U K
UK
Singla
N
N
Sharma
P P
PP
Behera
D
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000188:drug therapy*