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Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases

BACKGROUND: Childhood tuberculosis causes significant morbidity and mortality in Southeast Asia, yet little is known about the epidemiology and clinical characteristics of this disease in Viet Nam. OBJECTIVES: To determine the demographics, clinical presentations, radiographic and microbiologic find...

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Autores principales: Blount, Robert J., Tran, Bao, Jarlsberg, Leah G., Phan, Ha, Thanh Hoang, Van, Nguyen, Nhung Viet, Lewinsohn, Deborah A., Nahid, Payam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018290/
https://www.ncbi.nlm.nih.gov/pubmed/24818967
http://dx.doi.org/10.1371/journal.pone.0097267
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author Blount, Robert J.
Tran, Bao
Jarlsberg, Leah G.
Phan, Ha
Thanh Hoang, Van
Nguyen, Nhung Viet
Lewinsohn, Deborah A.
Nahid, Payam
author_facet Blount, Robert J.
Tran, Bao
Jarlsberg, Leah G.
Phan, Ha
Thanh Hoang, Van
Nguyen, Nhung Viet
Lewinsohn, Deborah A.
Nahid, Payam
author_sort Blount, Robert J.
collection PubMed
description BACKGROUND: Childhood tuberculosis causes significant morbidity and mortality in Southeast Asia, yet little is known about the epidemiology and clinical characteristics of this disease in Viet Nam. OBJECTIVES: To determine the demographics, clinical presentations, radiographic and microbiologic findings, treatment regimens, and outcomes of children admitted with tuberculosis (TB) to a national referral hospital in Viet Nam. METHODS: We conducted a retrospective case series study of children ≤ 15 years old with bacteriologically confirmed or clinically diagnosed TB admitted to a national referral hospital in Ha Noi, Viet Nam from January through December 2007. RESULTS: One hundred three children were identified: median age 5 years (IQR 2-10), 44% female, 99% Kinh ethnicity, 27% residing in Ha Noi, 88% with BCG vaccination, 27% with known TB contact, and 38% malnourished. Intrathoracic TB was present in 62%, extrathoracic in 52%, both intra and extrathoracic in 19%, and undetermined site in 5%. The most common extrathoracic manifestation was peripheral lymphadenitis, and children under 5 were more likely to have miliary TB or both intra and extrathoracic TB. Fever and failure to thrive were common presenting symptoms among all participants (65% and 56%, respectively), 66% of those with intrathoracic TB presented with cough, and 92% of those with TB meningitis presented with severe neurologic impairment. Acid-fast bacilli smears and mycobacterial cultures were positive in 18% and 21% of children tested, and histopathology was positive in 88% of those biopsied. There were no adverse drug reactions necessitating change in therapy, and no inpatient mortality. CONCLUSIONS: Extrathoracic TB was common, treatment well tolerated and clinical outcomes excellent. Culture confirmation rates were low and emphasize the need for improved diagnostics.
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spelling pubmed-40182902014-05-16 Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases Blount, Robert J. Tran, Bao Jarlsberg, Leah G. Phan, Ha Thanh Hoang, Van Nguyen, Nhung Viet Lewinsohn, Deborah A. Nahid, Payam PLoS One Research Article BACKGROUND: Childhood tuberculosis causes significant morbidity and mortality in Southeast Asia, yet little is known about the epidemiology and clinical characteristics of this disease in Viet Nam. OBJECTIVES: To determine the demographics, clinical presentations, radiographic and microbiologic findings, treatment regimens, and outcomes of children admitted with tuberculosis (TB) to a national referral hospital in Viet Nam. METHODS: We conducted a retrospective case series study of children ≤ 15 years old with bacteriologically confirmed or clinically diagnosed TB admitted to a national referral hospital in Ha Noi, Viet Nam from January through December 2007. RESULTS: One hundred three children were identified: median age 5 years (IQR 2-10), 44% female, 99% Kinh ethnicity, 27% residing in Ha Noi, 88% with BCG vaccination, 27% with known TB contact, and 38% malnourished. Intrathoracic TB was present in 62%, extrathoracic in 52%, both intra and extrathoracic in 19%, and undetermined site in 5%. The most common extrathoracic manifestation was peripheral lymphadenitis, and children under 5 were more likely to have miliary TB or both intra and extrathoracic TB. Fever and failure to thrive were common presenting symptoms among all participants (65% and 56%, respectively), 66% of those with intrathoracic TB presented with cough, and 92% of those with TB meningitis presented with severe neurologic impairment. Acid-fast bacilli smears and mycobacterial cultures were positive in 18% and 21% of children tested, and histopathology was positive in 88% of those biopsied. There were no adverse drug reactions necessitating change in therapy, and no inpatient mortality. CONCLUSIONS: Extrathoracic TB was common, treatment well tolerated and clinical outcomes excellent. Culture confirmation rates were low and emphasize the need for improved diagnostics. Public Library of Science 2014-05-12 /pmc/articles/PMC4018290/ /pubmed/24818967 http://dx.doi.org/10.1371/journal.pone.0097267 Text en © 2014 Blount et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Blount, Robert J.
Tran, Bao
Jarlsberg, Leah G.
Phan, Ha
Thanh Hoang, Van
Nguyen, Nhung Viet
Lewinsohn, Deborah A.
Nahid, Payam
Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases
title Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases
title_full Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases
title_fullStr Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases
title_full_unstemmed Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases
title_short Childhood Tuberculosis in Northern Viet Nam: A Review of 103 Cases
title_sort childhood tuberculosis in northern viet nam: a review of 103 cases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018290/
https://www.ncbi.nlm.nih.gov/pubmed/24818967
http://dx.doi.org/10.1371/journal.pone.0097267
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