| Objective The prevalence of pulmonary tuberculosis in Chinese adolescents is incr easing every year,which seriously affects the development and mental health of a dolescents.This study carried out a survey on the prevalence of tuberculosis in ad olescents,and investigated the clinical characteristics,life behaviors and dietary nut rition,providing a scientific basis for the effective prevention and control of tuber culosis in adolescents.Methods By cross-sectional survey,the clinical manifestations of 12239 tuberculosi s patients including cough,expectoration,hemoptysis,fever,clinical X-ray examina tion,sputum examination and management of treatment were collected in 7 countie s and districts of Shandong Province in Linyi from 2009 to 2013.The clinical ma nifestations of 3602 adolescent pulmonary tuberculosis pateinet(14~35 years old)a nd 3745 middle-aged and old-aged pulmonary tuberculosis patients(45~69 years ol d)were included and compared.In the second part,706 adolescent pulmonary tub erculosis patients were randomly selected and matched for age and sex with 736 h ealthy adolescents from the same community.The demographic information such a s age,gender,education level,life hygiene habits(smoking,drinking,staying up l ate,and exercising outdoors)and dietary nutrition information were collected and c ompared between the two groups.Results The result showed that adolescent TB patients accounted for 29.4% of the total number of people surveyed.Clinical symptom analysis showed that cough,expectoration,fever,fatigue,night sweating and anorexia were 95.0%,48.7%,46.3%,38.3%,21.8% and34.0% respectively.All of them were significantly lower in adolescent TB patients than that in middle-aged and old-aged patients with pulmonary tuberculosis(P<0.05);The proportion of asymptomatic patients in adolescent tuberculosis patients was 2.2%,which was significantly higher than that of middle-aged and elderly patients.Clinical examination analysis showed that the incidence of lung lesions in adolescent pulmonary tuberculosis patients was more than 3,and the incidence of cavitation and sputum positive were 22.6%,11.8% and 51.5%,respectively,which were significantly lower than those of middle-aged and elderly pulmonary tuberculosis patients(P<0.05).According to the investigation of disease history,the proportion of BCG vaccine in the adolescent tuberculosis group was 39.9%,which was significantly higher than that of the middle-aged and elderly tuberculosis group(P<0.05).The proportion of adolescent tuberculosis patients who adhered on treatment was 55.7%,which was significantly lower than that of middle-aged and elderly patients with pulmonary tuberculosis(P<0.05).The proportion of adolescent pulmonary tuberculosis patients in the intensive treatment period was 43.4%,which was significantly higher than that of middle-aged and elderly patients with pulmonary tuberculosis(P<0.05).The recurrence rate of adolescent pulmonary tuberculosis patients was only 4.5%,which was significantly lower than that of middle-aged and elderly patients with pulmonary tuberculosis(P<0.05).The result indicated that poor lifestyle was associated with the occurrence of tuberculosis in adolescents.The proportion of smoking in adolescent tuberculosis p atients was significantly higher that that in the control group.The proportion of s taying up late in adolescent tuberculosis patients was significantly higher that that in the control group.While the proportion of more than 2 hour per day exercise was significantly lower in adolescent tuberculosis patients compared to that of c ontrol.Multivariate regression analysis showed that smoking and staying up late i ncreased the risk of tuberculosis in adolescents(OR=1.437 and OR=1.489),and 2hours per day outdoor exercise reduced the risk of tuberculosis in adolescents(OR=0.684).Dietary nutritional status survey analysis showed that the proportion of low b ody weight in adolescent tuberculosis patients was 15.3%,significantly higher than that of the control group(P<0.05).Univariate regression analysis showed that lo w body weight was a risk factor for adolescent tuberculosis.The average Dietary diversity score score of patients was 5.92 points,which was significantly lower th an that of the control group(6.21 points)(P<0.05).The average intake of vegetab les,poultry meat and aquatic products in adolescent tuberculosis patients were 163.34g/d,56.37g/d and11.70 g/d,which were significantly lower than that of the co ntrol population(P<0.05).The average protein intake of adolescent tuberculosis pat ients was 69.93g/d which was significantly lower than that(75.53g/d)of control a dolescents(P<0.05).The average intake of calcium,iron,zinc,vitamin A,vitamin C and vitamin E in adolescent tuberculosis patients were 315.52mg/d,19.95mg/d,9.95mg/d,319.58?g RAE/d,65.14mg/d and 14.67mg?-TE/d,respectively,which we re significantly lower than the control group(P<0.05).Conclusion: Compared to the middle and elder aged patients,the adolescent pulmonary tuberculosis patients exhibited less obvious clinical manifestation with lo wer rate of complications,voids and positive sputum examination.This would pote ntially causes misdiagnosis,delayed treatment and a source of infection.In additio n,the occurrence of tuberculosis in adolescent was positively associated with smok ing,staying up late,opening windows,less outdoor exercise,less health education and poor nutrition status.Overall adolescent pulmonary tuberculosis patients displa yed less obvious symptoms and were associated with unhealthy lifestyle and poor nutrition status.Appropriate nutrition supplementation and education on healthy life style would be potentially helpful in preventing and controlling of TB in adolesce nts. |
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