title: Childhood tuberculosis in northern Viet Nam: a review of 103 cases.
abstract: BACKGROUND
  Childhood tuberculosis causes significant morbidity and mortality in Southeast Asia, yet little is known about the epidemiology and clinical characteristics of this disease in Viet Nam.
  
  
  OBJECTIVE
  To determine the demographics, clinical presentations, radiographic and microbiologic findings, treatment regimens, and outcomes of children admitted with tuberculosis (TB) to a national referral hospital in Viet Nam.
  
  
  METHODS
  We conducted a retrospective case series study of children ≤ 15 years old with bacteriologically confirmed or clinically diagnosed TB admitted to a national referral hospital in Ha Noi, Viet Nam from January through December 2007.
  
  
  RESULTS
  One hundred three children were identified: median age 5 years (IQR 2-10), 44% female, 99% Kinh ethnicity, 27% residing in Ha Noi, 88% with BCG vaccination, 27% with known TB contact, and 38% malnourished. Intrathoracic TB was present in 62%, extrathoracic in 52%, both intra and extrathoracic in 19%, and undetermined site in 5%. The most common extrathoracic manifestation was peripheral lymphadenitis, and children under 5 were more likely to have miliary TB or both intra and extrathoracic TB. Fever and failure to thrive were common presenting symptoms among all participants (65% and 56%, respectively), 66% of those with intrathoracic TB presented with cough, and 92% of those with TB meningitis presented with severe neurologic impairment. Acid-fast bacilli smears and mycobacterial cultures were positive in 18% and 21% of children tested, and histopathology was positive in 88% of those biopsied. There were no adverse drug reactions necessitating change in therapy, and no inpatient mortality.
  
  
  CONCLUSIONS
  Extrathoracic TB was common, treatment well tolerated and clinical outcomes excellent. Culture confirmation rates were low and emphasize the need for improved diagnostics.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Blount
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Bao
authors.initials: B
authors.lastname: Tran
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Leah G
authors.initials: LG
authors.lastname: Jarlsberg
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Ha
authors.initials: H
authors.lastname: Phan
authors.affiliation: National Lung Hospital, Ha Noi, Viet Nam; Viet Nam National Tuberculosis Program, Ha Noi, Viet Nam.
authors.forename: Van
authors.initials: V
authors.lastname: Thanh Hoang
authors.affiliation: National Lung Hospital, Ha Noi, Viet Nam; Viet Nam National Tuberculosis Program, Ha Noi, Viet Nam.
authors.forename: Nhung Viet
authors.initials: NV
authors.lastname: Nguyen
authors.affiliation: Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States of America.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Lewinsohn
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Payam
authors.initials: P
authors.lastname: Nahid
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013812:Therapeutics; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D014744:Vietnam / Q000453:epidemiology