Predictors of Microbiologically Confirmed Intrathoracic Tuberculosis
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To identify risk factors for microbiologically confirmed intrathoracic tuberculosis in children.
Children, 6 mo to 15 y of age, attending the out-patient department of a tertiary care centre in India, with probable intrathoracic tuberculosis were enrolled. Microbiological confirmation of tuberculosis was defined as positivity on smear (Ziehl-Neelsen staining) and/or Xpert MTB/RIF and/or MGIT-960 culture. Association of various factors with microbiological confirmation were assessed by univariate and multivariate analysis.
Microbiologic confirmation was documented in 39 (25%) of 153 patients enrolled. On univariate analysis, microbiological positivity was associated with female gender, higher mean (SD) age [136.6 (31.8) vs. 117.3 (41.4) mo], parenchymal lesion on chest radiograph, low body mass index for age, having symptoms of cough and weight loss, lower mean (SD) hemoglobin [10.4 (1.37) g/dl vs. 11(1.52) g/dl; p = 0.04], and higher mean (SD) monocyte: lymphocyte ratio [0.38 (0.30) vs. 0.24 (0.02); p = 0.37]. Higher proportion of microbiologically negative children were BCG vaccinated (95% vs. 79%; p = 0.002). On multivariate analysis, microbiological positivity showed significant association with low body mass index for age (p = 0.033) and higher monocyte: lymphocyte ratio (p = 0.037).
Low body mass index for age and higher monocyte: lymphocyte ratios were associated with microbiological confirmation in children with intrathoracic tuberculosis.
KeywordsChildhood tuberculosis MGIT culture Intrathoracic tuberculosis Predictors
The authors acknowledge the support of the technical staff of TB Lab, Department of Microbiology, AIIMS.
RJ collected data and prepared the manuscript; MS helped in collecting data; SKK and RL conceptualized and designed the study; AM analysed the data; UBS, YV, HG did microbiological investigations; SKK, RL and AM drafted the manuscript. All authors approved the final manuscript. SKK will act as guarantor for this paper.
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Conflict of Interest
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