Clinical Epidemiological Characteristics Of 920 Children With Pulmonary Tuberculosis

Objective:To analyze the clinical epidemiological characteristics of PTB(pediatric pulmonary tuberculosis,PTB)patient,to improve the understanding and diagnostic level of the pulmonary tuberculosis,and to help for the prevention and control of pulmonary tuberculosis.Methods:A retrospective,descriptive study was undertaken among PTB patients from 2010 to 2015 in the hospital,we collected the clinical data and evaluated related factors.Results:A total of 920 children with PTB were enrolled,among whom there were 526 boys and 394 girls,the peak age at onset was 7~14 years.651(70.8%)from country,250(27.2%)from city.621 cases(67.5%)were vaccinated with BCG,and 356 cases(38.7%)had a history of tuberculosis exposure,pulmonary tuberculosis complicated with tuberculous meningitis were mainly observed in patients with clear evidence for tuberculosis exposure(30.3%)compared to the patients without tuberculosis exposure(24.4%)and the patients with unknown evidence for tuberculosis exposure(16.8%)(?2=9.609,P =0.008).355 cases(37.9%)were diagnosed by etiology or pathology,and 565 cases(62.1%)were diagnosed clinically.48.9% of patients were complicated with extrapulmonary tuberculosis,and the most commonly seen was tuberculous meningitis(52.4%).The most common suspicious symptoms of pulmonary tuberculosis were fever and cough,80.4% and 71.3% respectively,and there were no significant difference in poisoning symptoms of tuberculosis and ages(?2=2.534,P=0.639).The positive rate of sputum/gastric bacterium smear and culture was 26.9% and 26.8% respectively;and the positive rate of IFN-?(81.5%)was higher than the sputum/gastric bacterium smear(26.9%),PPD(44.1%)and mycobacterium tuberculosis-PCR(29.6%).CT scanning was superior to X-ray examination in all aspects.The girls,ages 0-3,rural and PPD negative are independent risk factors for children with severe tuberculosis.Conclusions : Pediatric pulmonary tuberculosis is featured with atypical clinical performance,low etiological positive rate,so it should be emphasized that the diagnosis of Pediatric PTB should be based on a comprehensive assessment of tuberculosis exposure,clinical manifestations,and related tests,with a high degree of awareness of risk factors for severe tuberculosis,to prevent and treat PTB Promptly and Effectively.