Pediatric Tuberculosis at Moulay Youssef University Hopsital – Morocco

Abstract

Background: There are few studies on presentations, treatment and outcomes of pediatric tuberculosis in Morocco. This study aimed to describe clinico-epidemiological profiles, laboratory findings, treatment and outcomes of pediatric tuberculosis (TB) in a tertiary care hospital in Morocco. Materials and Methods: This is a prospective, descriptive study undertaken in children diagnosed with TB between June 2011 and May 2012. Clinico-pidemiologicalprofiles, laboratory findings, treatment and outcome of patients was recorded. Statistical significance of category variables was evaluated. Analysis was done on SPSS package. Results were expressed as rates and proportions. Chi square test was used to test for statistical significance. Results: 53 children aged 2 to 16 years (mean age of 9±3.2) with TB diagnosis were enrolled in our study. 33 (62%) of patients were female. Common symptoms were fever, cough, chest pain, dyspnea, decreased appetite and weight loss. The types of TB were: pulmonary TB (32, 60%), and extrapulmonary TB (21, 39.6%). The sites of pediatric extrapulmonary tuberculosis (EPTB) were: lymph nodes (7, 13.2%), peritoneal (6, 11.3%), meningeal (4, 7.5%) and osteoarticular (4, 7.5%). 24 (45,3%) of the patients had positive Calmette-Guérin vaccine scar, and 42(79.2%) of the patients had a positive tuberculin skin test. An adult TB contact was identified in 19 (35.8%) of the cases. On direct microscopy, acid-fast bacilli were found in 3 (5.6%) patients and positive cul¬ture for Mycobacterium tuberculosis was found in 2 (3.7%). Drug mono- or multiresistance was not detected. Conclusion: Paediatric TB in both pulmonary and extrapulmonary forms is a challenging diagnosis, and is a common occurrence in our setting. Diagnosis was based on a combination of epidemiological and clinical suspicion supported by results of various investigations.