title: Sociodemographic, Epidemiological, and Clinical Risk Factors for Childhood Pulmonary Tuberculosis in Severely Malnourished Children Presenting With Pneumonia: Observation in an Urban Hospital in Bangladesh.
abstract: We aimed to evaluate sociodemographic, epidemiological, and clinical risk factors for pulmonary tuberculosis (PTB) in children presenting with severe acute malnutrition (SAM) and pneumonia. Children aged 0 to 59 months with SAM and radiologic pneumonia from April 2011 to July 2012 were studied in Bangladesh. Children with confirmed PTB (by culture and/or X-pert MTB/RIF) (cases = 27) and without PTB (controls = 81; randomly selected from 378 children) were compared. The cases more often had the history of contact with active PTB patient (P < .01) and exposure to cigarette smoke (P = .04) compared with the controls. In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with working mother (P = .05) and positive tuberculin skin test (TST; P = .02). Thus, pneumonia in SAM children is a common presentation of PTB and further highlights the importance of the use of simple TST and/or history of contact with active TB patients in diagnosing PTB in such children, especially in resource-limited settings.
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Mohammod Jobayer
authors.initials: MJ
authors.lastname: Chisti
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Abu S M S B
authors.initials: AS
authors.lastname: Shahid
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: K M
authors.initials: KM
authors.lastname: Shahunja
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Pradip Kumar
authors.initials: PK
authors.lastname: Bardhan
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Abu Syeed Golam
authors.initials: AS
authors.lastname: Faruque
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Sumon Kumar
authors.initials: SK
authors.lastname: Das
authors.affiliation: International Centre for Diarhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Mohammed Abdus
authors.initials: MA
authors.lastname: Salam
keywords: children; history of contact; pneumonia; pulmonary tuberculosis; severe acute malnutrition; tuberculin skin test