Clinical Presentations and Outcomes Related to Tuberculosis in Children Younger Than 2 Years of Age in Catalonia
Soriano-Arandes, Antoni (Hospital Universitari Vall d'Hebron)
Brugueras Torrella, Silvia (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Rodríguez Chitiva, Alejandro (Hospital Universitari Vall d'Hebron)
Noguera-Julian, Antoni (Red de Investigación Translacional en Infectología Pediátrica (RITIP))
Orcau, Àngels (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Martín-Nalda, Andrea (Hospital Universitari Vall d'Hebron)
Millet, Joan-Pau (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Vallmanya, Teresa (Hospital Arnau de Vilanova (Lleida, Catalunya))
Méndez, Maria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Coll-Sibina, Maite (Hospital General de Granollers)
Mayol, Lluís (Hospital Universitari de Girona Doctor Josep Trueta)
Clopés, Asumpció (Pediatrics, Hospital Pius)
Pineda, Valentí (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
García, Lourdes (Pediatrics, Consorci Sanitari del Maresme)
López, Nuria (Hospital del Mar (Barcelona, Catalunya))
Calavia, Olga (Hospital Universitari Joan XXIII de Tarragona)
Rius, Neus (Hospital Universitari Sant Joan de Reus (Tarragona))
Pérez-Porcuna, Tomás M. (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Soler-Palacín, Pere (Hospital Universitari Vall d'Hebron)
Caylà, Joan A.. (Fundació de la Unitat d'Investigació en Tuberculosi de Barcelona)

Date:	2019
Abstract:	Introduction: Children younger than 2 years have an increased risk of complications associated with tuberculosis (TB) due to the immaturity of the innate and adaptive immune response. We aimed to identify TB clinical presentations and outcomes as well as risk factors for complications in this age group. Materials and Methods: Multicenter, retrospective, cross-sectional study of TB cases in children aged <2 years in Catalonia (2005-2013). Epidemiological and clinical data were collected from the hospital medical records. TB complications, sequelae included, were defined as any tissue damage generating functional or anatomical impairment after being diagnosed or after TB treatment being completed. Statistical analyses were based on bivariate chi-square and multivariate logistic regression, and it was carried out with Stata® version 13. 1. Odds ratios (OR) and its 95% confidence intervals were calculated (CI). Results: A total of 134 patients were included, 50. 7% were male, the median [IQR] age was 13[8-18] months, and 18. 7% (25/134) showed TB-associated complications. Pulmonary TB was diagnosed in 94. 0% (126/134) of children, and the most common complications were lobar collapse (6/126). TB meningitis was diagnosed in 14/134 (10. 4%), and hydrocephalus and mental impairment occurred in 1 and 2 patients, respectively. Two patients with spinal TB developed vertebral destruction and paraplegia, respectively. Only one of the patients died. At multivariate level, tachypnea (OR = 4. 24; 95% CI 1. 17-15. 35) and meningeal (OR = 52. 21; 95% CI 10. 05-271. 2) or combined/extrapulmonary forms (OR = 11. 3; 95% CI 2. 85-45. 1) were associated with the development of TB complications. Discussion: TB complications are common in children under 2 years old. Extrapulmonary TB forms in this pediatric age remain a challenge and require prompt diagnosis and treatment in order to prevent them. The presence of tachypnea at the time of TB diagnosis is an independent associated factor to the development of TB complications in infants. This clinical sign should be closely monitored in patients in this age group. It is necessary to perform further studies in this age group in a prospective design in order to understand whether there are other factors associated to TB complications.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Tuberculosis ; Infants ; Low-incidence country ; Complications ; Sequelae ; Risk factors
Published in:	Frontiers in Pediatrics, Vol. 7 (june 2019) , ISSN 2296-2360

DOI: 10.3389/fped.2019.00238
PMID: 31245340

10 p, 392.2 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles