Clinical presentations and outcomes related to tuberculosis in children younger than 2 years of age in Catalonia

Full item page Simple item page

• dc.contributor.author Soriano-Arandes, Antoni
• dc.contributor.author López Segura, María Nuria
• dc.contributor.author Caylà i Busqueras, Joan A.
• dc.date.accessioned 2020-01-17T08:00:55Z
• dc.date.available 2020-01-17T08:00:55Z
• dc.date.issued 2019
• dc.description.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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Soriano-Arandes A, Brugueras S, Rodríguez Chitiva A, Noguera-Julian A, Orcau À, Martín-Nalda A, Millet JP. Et al. Clinical Presentations and Outcomes Related to Tuberculosis in Children Younger Than 2 Years of Age in Catalonia. Front Pediatr. 2019 Jun 11;7:238. DOI 10.3389/fped.2019.00238
• dc.identifier.doi http://dx.doi.org/10.3389/fped.2019.00238
• dc.identifier.issn 2296-2360
• dc.identifier.uri http://hdl.handle.net/10230/43305
• dc.language.iso eng
• dc.publisher Frontiers
• dc.rights Copyright © 2019 Soriano-Arandes, Brugueras, Rodríguez Chitiva, Noguera-Julian, Orcau, Martín-Nalda, Millet, Vallmanya, Méndez, Coll-Sibina, Mayol, Clopés, Pineda, García, López, Calavia, Rius, Pérez-Porcuna, Soler-Palacín and Caylà. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) https://creativecommons.org/licenses/by/4.0/. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Complications
• dc.subject.keyword Infants
• dc.subject.keyword Low-incidence country
• dc.subject.keyword Risk factors
• dc.subject.keyword Sequelae
• dc.subject.keyword Tuberculosis
• dc.title Clinical presentations and outcomes related to tuberculosis in children younger than 2 years of age in Catalonia
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion