Publication:

A study on prevalence of symptomatic not confirmed pulmonary tuberculosis under 5 to 15 years of age in protein energy malnutrition children in a tertiary care centre

Background Tuberculosis (TB) and malnutrition are important causes of morbidity and mortality in  children, in developing countries. Tuberculosis  can be a  cause of  malnutrition in children and also a common cause of pneumonia  in such malnourished children. In the present study ,our aim is to know the  prevalence and early clinical diagnosis of symptomatic not confirmed TB, in recent challenging environment,  in protein energy malnutrition  children, this information would certainly help clinicians in early detection, diagnosis and management of PTB (Pulmonary Tuberculosis) in such populations ,to reduce morbidity and mortality.

Methods We prospectively investigated protein energy malnutrition children, with clinical features of tuberculosis, between 5 to 15 years of age , admitted during 18 months of study period. Clinical and demographic data  of studied children were collected. Anthropometric (Height and Weight) measurement and physical examination were made. PEM (Protein energy malnutrition) children were classified according to Indian academy of pediatric classification. History of BCG vaccination and exposure to contact were inquired. Chest radiography was done for all  children in our study.

Results A total of 150 protein energy malnutrition children, between 5 to 15 years, admitted over 18 months  period were  studied. Majority of children were female as compared to male and under 5 to 10 years of age. Out of these, symptomatic not confirmed pulmonary TB 93 (62%) and Extra pulmonary TB 18 (12%) and Non TB cases were 39 (26%). According to Grade of PEM, symptomatic not confirmed pulmonary TB cases under grade III were 45 (48.5%) and 35 (37.6%) were under grade II .

Conclusions Pulmonary tuberculosis may be a common cause of pneumonia in malnourished children and  the cause of death in these population. So  Its frequency and early clinical detection ,even without microbiological confirmation and supportive evidence and treatment guideline should be made by more further study. So that, it  will help clinicians to treat these population to reduce morbidity and mortality.