FEATURES OF ADOLESCENTS TUBERCULOSIS AT A REFERRAL TB'S HOSPITAL IN TEHRAN, IRAN

Main Article Content

Ferial Lotfian
Mohammad Reza Bolursaz
soheila Khalilzadeh
Noshin Baghaie
Maryam Hassanzad
Aliakbar Velayati

Keywords

adolescents, tuberculosis, Lost to follow-up, prevention

Abstract

 

Abstract

OBJECTIVE: To identify the pattern of the clinical, radiological, diagnostic procedures and loss to follow -up of the diagnosed cases of active tuberculosis (TB) adolescents.

METHODS: This study was a retrospective analysis of the medical records of 143 adolescents aged 10 to 18 years with tuberculosis who were admitted TB wards of National Research Institute of Tuberculosis and Lung Disease (NRITLD) in Tehran, Iran, between March 2006 and March2011.

RESULTS: Of the 143 patients identified, 62.9% were females. Median age of the patients was 16 years. The contact source was identified in 47.5%.The most common presenting symptom was cough (86%).Isolated pulmonary TB (PTB) was detected in 113 patients (79%), 21 patients (14.7%) had extrapulmonary TB(EPTB), and 9 patients (6.3%) had PTB and EP TB .The most common site of  EPTB was pleural (14%) .The most common radiographic finding was infiltration (61%).Positive acid fast smears were seen in 67.8%.Positive cultures for Mycobacterium tuberculosis(M. TB) were seen in 31.6%. Positive PCR results were seen in 60%.The adolescents aged 15 to 18 years were more likely to lose weight (p=0.001), smear positive (p=0.002)and have positive PCR results (p=0.009). The type of TB (p=0.017) was a significant factor influencing loss to follow-up.

CONCLUSIONS: Adolescents with the high rate of positive sputum smear results and the high treatment default rate are more likely to increase risk for TB transmission to the community. The TB control programs should pay more attention to prevention and treatment of TB in adolescents.

 

 

Key words: adolescents, tuberculosis, Lost to follow-up, prevention

 

 

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References

References:
1. World Health Organization, Geneva. Global Tuberculosis Report 2013. Link:http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_
eng.pdf?ua=1(Accessed 26/10/2013)
2. World Health Organization (WHO). Global Health Observatory Data Repository 2013. Available from: http://appswho int/ghodata. 2013
3. Wood R, Lawn SD, Caldwell J, et al. Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status. PLoS One .2011 ;6: e25098.
4 .Phongsamart W, Kitai I, Gardam M, Wang J, Khan K. A population-based study of tuberculosis in children and adolescents in Ontario. Pediatr Infect Dis J. 2009 May;28(5):416-9. [PubMed]
5. Nejat S, Buxbaumc C, Eriksson M , Pergert M, Bennet R. Pediatric Tuberculosis in Stockholm: A Mirror to the World.Pediatr Infect Dis J. 2012;31(3):224-7.
6. Winston CA, MenziesHJ. Pediatric and adolescent tuberculosis in the United States, 2008-2010. Pediatrics. 2012 Dec;130(6):e1425-32.
7. Didilescu C, Ibraim E, Tig?u M. “The epidemiological profile and current evolutionary trends in tuberculosis in adolescents (15–19 years old) in the capital,” Pneumoftiziologia, vol. 46, no. 3, pp. 193–199, 1997. View at Scopus

8. Kam A, Ford-Jones L, Malloy P, Khan K, Kitai I. Active tuberculosis among
adolescents in Toronto, Canada: Clinical features and delays in diagnosis. The Pediatric
infectious disease journal. 2007;26(4):355.
9. World Health Organization, online article; Adolescent Health. Link:http //www.who.int/topics/adolescent_health/en/(Accessed:26/10/2013)

10. World Health Organization Treatment of tuberculosis: guidelines WHO/HTM/TB/2009.420 (4th ed.) (2009)


11. World Health Organization. Online article: Gender and Tuberculosis. Link: whqlibdoc.who.int/gender/2002/a85584.pdf (Accessed12/12/2013)

12. Thorson A. Tuberculosis and Gender. Denmark: WHO European Ministerial Forum; 2007 Sep(EUR/TB/FS05).
13. Cruz AT, Hwang KM, Birnbaum GD, Starke JR. Adolescents with tuberculosis: a review of 145 cases. Pediatr Infect Dis J. 2013 Sep;32(9):937-41.
14. de Pontual L, Balu L, Ovetchkine P, et al. Tuberculosis in adolescents: A French retrospective study of 52 cases. Pediatr Infect Dis J. 2006 Oct;25(10):930-2.
15. Yang Z, Kong Y, Wilson F, et al. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis 2004;38:199-205
16. Walls T, Shingadia D .Global epidemiology of paediatric tuberculosis. J Infect. 2004 Jan;48(1):13-22
17. Weber HC, Beyers N, Gie RP, et al. The clinical and radiological features of tuberculosis in adolescents. Ann Trop Paediatr. 2000 Mar;20(1):5-10.

18. Buonsenso D, Lancella L, DeloguG , et al. A twenty-year retrospective study of pediatric tuberculosis in two tertiary hospitals in Rome. Pediatr Infect Dis J. 2012 Oct;31(10):1022-6. doi: 10.1097/INF.0b013e3182615270
19. Schaaf HS, Marais BJ, Whitelaw A, et al. Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. BMC Infect Dis. 2007 Nov 29;7:140.
20. Blount RJ, Tran B, Jarlsberg LG, et al. Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases. PLoS One. 2014 May 12;9(5):e97267. doi: 10.1371/journal.pone.0097267. eCollection 2014.
21. Matos TP, Kritski AL, RuffinoNettoA. Epidemiological aspects of tuberculosis in children and ado de Janeiro.JPediatr (R lescents in Rio io J). 2012 Jul;88(4):335-40.
22. CantaliceFilho JP, Sant Anna CC, Bóia MN. Clinical aspects of pulmonary tuberculosis in elderly patients from a university hospital in Rio de Janeiro, Brazil.J Bras Pneumol. 2007;33(6):699-706.
23. Akto?u S, Yorgancioglu A, Cirak K, Köse T, Dereli SM. Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5,480 cases.EurRespir J. 1996 Oct;9(10):2031-5.
24. Lawson L, Yassin MA, Thacher TD, et al. Clinical presentation of adults with pulmonary tuberculosis with and without HIV infection in Nigeria. Scandinavian Journal of Infectious Diseases, 2008; 40: 30_35.

25. Nelson LJ, Schneider E, Wells CD, Moore M. Epidemiology of childhood
tuberculosis in the United States, 1993-2001: the need for continued vigilance. Pediatrics.2004 Aug;114(2):333-41.
26. Boloursaz MR, Khalilzadeh S, Baghaie N, Khodayari AA, VelayatiAA.Radiologic manifestation of pulmonary tuberculosis in children admitted in pediatric ward-MassihDaneshvari Hospital: a 5-year retrospective study. Acta Med Iran. 2010 Jul-Aug;48(4):244-9.
27. Gie R. Diagnostic atlas of intrathoracic tuberculosis in children Paris ,France: International Union Against Tuberculosis and Lung Disease,2003.
28. Sant'Anna C, March MF, Barreto M, Pereira S, Schmidt C. Pulmonary tuberculosis in adolescents: radiographic features. Int J Tuberc Lung Dis. 2009 Dec;13(12):1566-8.
29. www.who.int/iris/9789241506137_ .World Health Organization."Roadmap for childhood tuberculosis: towards zero deaths." Geneva: WHO (2013).

30. Telenti A and Iseman M. Drug-resistant tuberculosis: what do we do now?
Drugs, 2000;59(2), 171-179.
31. KarSB,Alex Sand R AlcalayR. The Effectiveness of Peer Education STD/HIV
Prevention in Health Communication: A Multicultural Perspective, Sage Publications. Pub. date: 2001 | Online Pub. Date:May 31, 2012.DOI:http://dx.doi.org/10.4135/9781452220628

32. Self M , Murphy R, Marcattilio A, Jensen M and Gasparotto G. The use of
contingency contracting to increase adherence to a diabetic diet. American Journal of HealthPromotion, 1996; 10(5), 407-408.

33. Wu XR, Yin QQ, Jiao AX, et al. Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010.Pediatrics. 2012 Dec;130(6):e1433-40.
34. Ade S , Harries AD, Trébucq A, et al. National Profile and Treatment Outcomes of Patients with Extrapulmonary Tuberculosis in Bénin. PLoS ONE 2014;9(4): e95603. doi:10.1371/journal.pone.0095603
35. Endris M, Moges F, Belyhun Y, et al. Treatment Outcome of Tuberculosis Patients at EnfrazHealthCenter, Northwest Ethiopia: A Five-Year Retrospective Study. Hindawi Publishing Corporation Tuberculosis Research and Treatment Volume 2014, Article ID 726193, 7 pages. http://dx.doi.org/10.1155/2014/726193.

36. Santha T, Garg R, Frieden TR, et al .Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur District, South India, 2000. Int J Tuberc Lung Dis. 2002 Sep;6(9):780-8.
37. Ukwaja KN, Ifebunandu NA, Osakwe PC, Alobu I .Tuberculosis treatment outcome and its determinants in a tertiary care setting in south-eastern Nigeria. Niger Postgrad Med J. 2013 Jun;20(2):125-9.
38. Sandgren A, Hollo V, van der Werf MJ .Extrapulmonary tuberculosis in the European Union and European Economic Area, 2002 to 2011. Euro Surveill 18(12): pii = 20431. (Accessed Dec 9,2013, at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20431. )

39. Adolescent TB, Tuberculosis control in an adolescent population: training manual for an innovative educational program. (Accessed Dec 9,2013 ,at http://www.ph.ucla.edu.)