Abstract:

Objectives: Pediatric tuberculosis is a major public health problem. Malnutrition characterized with wasting is prevalent among pediatric tuberculosis patients. We aimed to review pediatric tuberculosis cases by considering their nutrition manifestations.  Materials and Methods: The study evaluated demographical, clinical, anthropometric, microbiological, histopathological and radiological characteristics of tuberculosis patients, retrospectively.  Results: The study involved 77 tuberculosis cases. Sixty-three percent of the patients were male with a mean age of 9.32±4.91 years. Twenty-four patients (31%) diagnosed with definite tuberculosis, thirty-nine patients (50%) with probable tuberculosis, and fourteen patients (18%) with latent tuberculosis infection. Acid resistant bacteria were observed in 33%, culture positivity was observed in 20%, both acid resistant bacteria and culture positivity was observed in 45% of definite diagnosed group. Forty percent of patients had pulmonary, 32% had extrapulmonary, 6% had miliary, 2% had both pulmonary and extrapulmonary tuberculosis. Pulmonary tuberculosis diagnosed patients were significantly older than extrapulmonary plus miliary group (p=0.003). Culture positivity rate was significantly higher in pulmonary, diagnostic histopathological sampling rate was significantly higher in extrapulmonary plus miliary group (p=0.019, p=0.012). Thirty seven percent of patients had a contact history, 23% of those had household contact, and the most common index cases were fathers. The tuberculin test was positive in 11 patients (45%) with definite and 15 patients (38%) with probable tuberculosis. No significant difference has been observed between definite and probable tuberculosis groups according to the sex, average age, symptom duration, tuberculin test positivity, Bacille Calmette-Guerin vaccine scar presence, contact history rate, hematologic tests, and anthropometric measurements (p>0.05). At the time of diagnosis mean (SD) values of height for age and weight for height medians [ 94.35 (7.50) % and 85.72 (6.92) %, respectively] refered to mild malnutrition, the same conditions were remaining at the end of treatment. When height for age taken into consideration the chronic malnutrated group was probable tuberculosis group. Weight for height (for <5 years old cases) and body mass index (for ≥5 years old cases) Z scores of sixteen patients were less than -2 SD value and these moderae malnutrated cases were remaining at the end of treatment. There was not a statistical significance between anthropometric measurements at the time of diagnosis and at the end of antituberculosis treatment (p>0.05).  Conclusion: Nutrition status monitoring, correcting nutritional deficiencies and failures can be neglected in course of antituberculosis treatment. Tuberculosis management should be integrated with malnutrition monitoring in pediatric cases. 

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