Prevalence of paediatric TB reflects health awareness and efficacy of national program, it is constantly increasing in India. The aim of study was to determine the prevalence of TB among children (<8 year) exposed to sputum positive adult & find out relation of TB prevalence with following variable; BCG status, nutritional and socio-economic-status (SES) and sputum positivity of index case & family size.
Selection of index case was done by history, radiology and sputum examination by ZN method. Screening of 100 children done by history, physical examination, MT with 5TU, radiological & blood investigation.
Children tested according to age group were: 0-1 year (n=14), 1-3 years (n=28), 3-5 years (n=24) and 5-8 years (n=34). Among these groups 50%, 42%, 37% & 8% children were affected respectively. Male : female ratio was 1.8 : 1. Majority of children were asymptomatic (67.7%). Among symptomatics (32.2%) chief symptom were fever (31.2%), cough (9.6%), nodular swelling on neck (13.9%). Chief signs were pallor (81%), cervical lymph-nodes, chest sign (12.9% each), hepatomegaly (64%) and splenomegaly (19%). ESR was significantly elevated in infected children. Radiological findings were: hilar lymph-nodes (64.5%), Primary progressive complex (15.1%) & normal CXR (17.1%).
Tuberculosis prevalence was 31% in such children & most was apparently asymptomatic. Factors significantly associated with increased risk of infection were; male-sex 0-3 years age low-SES, over crowding in home, sleeping in same room, sputum positivity of index case, if index case is mother/father and malnourishment. It was inversely related to BCG-vaccination status.
All the children in close contact with adult tuberculosis case must be screened thoroughly. Whenever we see a tuberculosis child, we should search for an adult case in the family. Promotion of institutional deliveries and BCG vaccination at birth along with improving nutritional status.
M. Vats, None.