title: Childhood tuberculosis: A descriptive study in a pneumo-pediatrics department in Tunisia.
abstract: Objective to assess the different localizations of tuberculosis (TB) in children in a pneumopediatric department in Tunisia and to describe its diagnosis tools since clinical investigations of childhood TB are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. Methods Forty-six cases of TB in children were studied between 2008 and 2013. Clinical history, examination and chest radiography were reported. Several investigations have been conducted to confirm the diagnosis of TB such as: tuberculin skin test (TST), bacteriological and histological investigations. Anti-tuberculosis treatment was prescribed according to the national guidelines. Results Cough and deterioration in general condition were the most frequent symptoms (47.8% and 43.7%). The other children presented cervical swelling (19.5%), chest pain (17.4%) and hemoptysis (4.3%). Abnormalities have been found in chest radiography in 35 cases (76%). TST was positive in 73% of cases. Diagnosis of TB was confirmed in 56.6% of cases by Mycobacterium tuberculosis (MT) isolation and/or biopsy. The diagnosis was made on presumptive arguments in 20 cases (43.4%) based on a history of TB contact, suggestive symptoms and a positive TST. A surgical biopsy was necessary for diagnosis in 17 cases (nasopharynx, bone, cervical, mediastinal and mesenteric lymph nodes). Pulmonary TB was diagnosed in 52% of cases. Two children were diagnosed with disseminated TB. A diagnosis delay was noted with an average of 20 days and a contact history was found in 52% of the children. All children were treated according to the national guidelines without major side effects. Healing without sequelae was achieved in 91% of cases. Conclusion Children represent a population at high risk for TB especially after a household contact with a higher frequency of multifocal forms compared to adults. The difficulty of the diagnosis in children may explain partially the diagnosis delay, but efforts must be done to improve prevention and diagnosis in our country.
authors.forename: Houda
authors.initials: H
authors.lastname: Snène
authors.forename: Anissa
authors.initials: A
authors.lastname: Berraies
authors.forename: Besma
authors.initials: B
authors.lastname: Hamdi
authors.forename: Jamel
authors.initials: J
authors.lastname: Ammar
authors.forename: Hanadi
authors.initials: H
authors.lastname: Ouali
authors.forename: Agnes
authors.initials: A
authors.lastname: Hamzaoui
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage*; D001706:Biopsy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D017410:Practice Guidelines as Topic; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014416:Tunisia / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents