CLINICAL PROFILE AND TREATMENT OUTCOME OF TUBERCULOUS LYMPHADENITIS IN CHILDREN USING DOTS STRATEGY

摘要

Summary:Background: Extra pulmonary TB (EPTB) including tuberculous lymphadenitis is becoming more common probably due to human immuno deficiency virus (HIV) co-infection. While children do experience a high TB related morbidity and mortality, management of TB in children is challenging. The present study was designed to study the treatment outcome of DOTS strategy for pediatric tuberculous lymphadenitis.Objective: To study the efficacy of DOTS strategy for pediatric lymphhnode tuberculosis.Methods: Retrospective analysis of 669 children of lymphnode tuberculosis treated with DOTS strategy over 91/2 years. Results: Mean age was 9.8 years with significantly more girls (61.3%) than boys (38.7%) (x~2=34.08, P< 0.001 (S)). Most of the patients were in the age group of 11-14 years (48.0%) followed by 6-10 years(34.5%) and 0-5 years(17.5%) respectively. Cervical tuberculous lymphadenitis (88.2%) was the commonest form for all ages followed by axillary lymphadenitis in 3.3%. TB of other sites was seen in only 57 (8.5%) cases. Out of total 622 (93%) cases of lymphnode TB where fine needle aspiration and/ or excisional biopsy was done, it was positive (84.2%) and negative (15.6%) respectively for AFB/ cytology, while it could not be done in 47 patients due to inaccessible sites. Category I, II and III was started on 15.4%, 7.5% and 77.1% patients respectively. Overall, treatment completion rate was 94.9% and the default rate was 2.2% with a failure rate of 2.5%. Death rate was 0.3%.Conclusion: The study confirms the efficacy of DOTS strategy for pediatric TB lymphadenitis.