Clinical analysis of epidemiological characteristics and risk factors related to severe cases of 876 children with pulmonary tuberculosis in a children hospital of Chongqing, China.

Abstract

Objective：By analyzing the epidemiological data of 876 children with Pulmonary Tuberculosis (PTB) and the risk factors of severe case. Methods: Retrospective analyzed the epidemiological related clinical data of 876 hospitalized children who were first diagnosed or clinically diagnosed with PTB at a Children's Hospital of Chongqing China from January 2016 to December 2020. Results: There were a total of 454 (51.83% ) cases with combined extrapulmonary tuberculosis. Hospitalization time ranged from 1 to 124 days, with a median length of 12 days and a inter-quartile range of 8 to 18 days. Gender distribution was that 479 (54.68%)cases were males and 397(45.32%)cases were females , with a male to female ratio of 1.21:1. The urban and rural distribution was that 431 (49.20%) cases were from city and 445(50.80%) cases were from countryside. The characteristic of age composition was that children over 3 years old had the most cases, with the main age range of 7-12 years old being 262 cases, followed by 12-15 years old with 206 cases(P<0.05). There were 285 (32.53%) cases with clear histories of tuberculosis exposure, and a higher proportion of children under 7 years old having a history of tuberculosis exposure, especially in the 0-1 year old age group (P<0.05). Among the 876 children with PTB, 768 (87.67%) cases had history of BCG vaccination, 59 (6.74%) cases had no vaccination history, and 49 (5.59%) cases had unknown vaccination history. The BCG vaccination rate difference was statistically significant in various years (c²=16.689, P=0.034). Through multiple factor binary logistic regression analysis, age<3 years old, residing in rural areas, not receiving BCG vaccine or unknown vaccination history were independent risk factors for the occurrence of severe PTB (P<0.05). Conclusions:This study showed that Children with PTB combined with extrapulmonary tuberculosis were common. In the 876 cases of tuberculosis in children, female cases more than male, rural cases more than urban. The younger children with tuberculosis, the more clear open tuberculosis contact history could be found. Age<3 years old, residing in rural areas, and not receiving BCG vaccination were independent risk factors for the occurrence of severe tuberculosis.