Jayasree Poroor1, Doye George2
INTRODUCTION: Adolescents are less frequently studied population as far as tuberculosis is concerned. And their response to the disease as well as clinical manifestations is different from children.
MATERIALS AND METHODS: A retrospective study was done on patients up to the age of 19 years and classified them in to child and adolescent. Up to 12 years was taken as child and beyond that as adolescent. Data collection was done from the RNTCP registers and medical records. The incidence of pulmonary, extra-pulmonary was found separately. Among pulmonary as well as the total intra-thoracic tuberculosis, sputum positivity was found. The incidence of lymph node tuberculosis, pleural effusion and others were also recorded. The records were checked to find out the completion/cure of disease and any record of relapse.
RESULTS: Total 67 patients were included in the study, 35 males and 32 females. 40.3% were adolescents and the rest were children. 48.14% were having pulmonary tuberculosis among adolescents while 85% in childhood had this presentation. (p-0.001). Intra-thoracic tuberculosis (pulmonary, intra-thoracic nodes and pleural effusion) occurred to 62.96% adolescents and 87.5% children. 53.84% of adolescents with pulmonary TB were sputum positive whereas in children it was only 18.7%. The increased chance of sputum positivity among adolescents was statistically significant (p-0.026). Among the total tuberculosis patients in each category, 29.6% adolescents had extra-thoracic lymph node tuberculosis while only 7.5% children had this (p-0.04). There were no statistically significant differences in other forms of extra-pulmonary tuberculosis. All patients were compliant and had completed treatment.
DISCUSSION AND CONCLUSIONS: Our adolescents had greater incidence of extra-thoracic Tb (37%) while Cruz et al found 18.6% of this type. Smear positivity of adolescents with intra-thoracic TB was also higher in our study (41.17%) compared to the other study (25%). Arora VK et al reported 54% smear positivity among adolescents with pulmonary TB, similar to us. Extra-pulmonary tuberculosis predominates in the adolescents compared to adults as per the studies done by de Pontual L et al and others. We could find that extra-pulmonary Tb was more common in adolescents compared to children. Compliance was not a problem unlike studies from other countries.
