PATHOMORPHOSIS OF EXTRAPULMONARY TUBERCULOSIS IN CHILDREN
Abstract
Aim. To study clinical and epidemiological aspects of pathomorphosis of extrapulmonary tuberculosis clinical forms.
Materials and Methods. Retrospective analysis of 138 case histories in children aged to 15 years, obtaining extrapulmonary tuberculosis treatment in a specialized children's hospital during 1988-2015 was carried out. Among them, in 103 children, clinical forms of extrapulmonary tuberculosis combined with respiratory tuberculosis and in 35 children independent forms of extrapulmonary tuberculosis were found. Studied stage (1988-2015) was divided into 3 periods: I – 1988-1997, II – 1998-2007, III – 2008-2015.
During 2008-2015, incomparison to previous periods, the number of cases of peripheral lymph node tuberculosis (PLN), meninges and central nervous system tuberculosis, bones and joints tuberculosis, and ocular tuberculosis decreased. In 2008-2015, the share of combined forms of meninges and central nervous system tuberculosis and ocular tuberculosis remained at 1998-2007 level. During 2008-2015, skin tuberculosis was not diagnosed. Nevertheless, in 2008-2015, in6.8±10.2 % of cases extrapulmonary tuberculosis combined with miliary tuberculosis, and in 5.8±10.4 % of cases the process characterized by lethal outcome, moreover 4.9±10.7% from them – in recent years. It is important that during period I, in 19.6±13.2 % of cases extrapulmonary tuberculosis combined with respiratory tuberculosis in reverse development phases, during period II – in 12.9±19.3 % of cases, during period III – in 23.8±21.2 % of cases.
Conclusion. Despite the reduction, extrapulmonary tuberculosis combined with severe forms of respiratory tuberculosis, which led to lethal outcome in children in 5.8±10.4% of cases. Tuberculosis epidemiological situation worsening, reversion of severe forms of tuberculosis with the development of extrapulmonary one and several organs injuries in children shows the necessity of social, preventive and therapeutic measures intensification among children.
Downloads
References
Aksenova, V. A., Baryshnikova, L. A., Sevost'yanova, T. A., Klevno, N. I. (2014). Tuberkulez u detei v Rossii i zadachi ftiziatricheskoi i obshchei pediatricheskoi sluzhby po profilaktike i rannemu vyyavleniyu zabolevaniya. Tuberkulez i bolezni legkikh, 3, 40–46.
Peto, H. M., Pratt, R. H., Harrington, T. A., LoBue, P. A., Armstrong, L. R. (2009). Epidemiology of Extrapulmonary Tuberculosis in the United States, 1993–2006. Clinical Infectious Diseases, 49 (9), 1350–1357. doi: 10.1086/605559
Kul'chavenya, E. V. (2008). Kontrol' vnelegochnogo tuberkuleza v Sibiri i na Dal'nem Vostoke. Problemy tuberkuleza i boleznei legkikh, 9, 16–19.
Baghaie, N., Khalilzade, S., Boloursaz, M. R., Khodayari, A. ., Velayati, A. A. (2010). Extrapulmonary tuberculosis in children: two years study. Acta Medica Iranica, 48 (4), 239–243.
Punga, V. V., Skachkova, E. I., Yakimova, M. A., Erokhin, V. V. (2006). Dinamika vozrastno-polovoi struktury zabolevaemosti tuberkulezom za 10 let v territoriyakh Rossiiskoi Federatsii, kuriruemykh GU TsNIIT RAMN. Problemy tuberkuleza i bolezni legkikh, 7, 16–20.
Chebotareva, A. A., Chebotareva, T. V., Oblogina, L. I., Kosinova, A. M., Permyakova, V. M. (2008). Metody vyyavleniya i klinicheskaya kharakteristika vnelegochnogo tuberkuleza u detei iz grupp riska. Problemy tuberkuleza i boleznei legkikh, 4, 11–17.
Bіlogortseva, O. І. (2013). Epіdemіchna situatsіya shchodo tuberkul'ozu u dіtei ta pokazniki protituberkul'oznoі roboti sered dityachogo naselennya v Ukraіnі u 2012 r. Ukraіns'kii pul'monologіchnii zhurnal, 3, 66–70.
Urbakh, V. Yu. (1975). Statisticheskii analiz v biologicheskikh i meditsinskikh issledovaniyakh. Moscow: Meditsina, 295.
Mintser, O. P., Ugarov, B. N., Vlasov, V. V. (1991). Metody obrabotki meditsinskoi informatsii. Kyiv: Vishcha shkola, 271.
Filippov, A. V., Ovsyankina, E. S., Denisova, L. S., Stakheeva, L. B. (2008). Sravnitel'nyi analiz zabolevaemosti tuberkulezom detei i podrostkov v Moskve i Penzenskoi oblasti. Problemy tuberkuleza i boleznei legkikh, 1, 6–10.
Mikhailova, Yu. V., Son, I. M., Skachkova, E. I., Strelikov, S. N. (2009). Rasprostranenie tuberkuleza sredi detei i podrostkov v Rossitsiskoi Federatsii (analiz dannykh ofitsial'noi statistiki). Problemy tuberkuleza i boleznei legkikh, 1, 5–10.
Tuberculosis annual report 2010-(3) childhood tuberculosis (2012). Kekkaku, 87 (8), 549–553.
Makarova, U. E. (2008). Lazeroterapiya v kompleksnom lechenii bol'nykh v rannei stadii tuberkuleza perifericheskikh limfaticheskikh uzlov. Problemy tuberkuleza i boleznei legkikh, 6, 15–18.
Swaminathan, S., Rekha, B. (2010). Pediatric Tuberculosis: Global Overview and Challenges. Clinical Infectious Diseases, 50 (s3), S184–S194. doi: 10.1086/651490
Verma, P., Jain, A., Patra, S. K., Gandhi, S., Sherwal, B. L., Chaudhary, M. (2010). Evaluation of polymerase chain reaction (PCR) using hupB gene in diagnosis of tuberculous lymphadenitis in fine needle aspirates. Indian J. Tuberculosis, 57, 128–133.
Hatwal, D., Chaudhari, S., Joshi, A. K., Rathaur, V. K. (2013). Patterns of extrapulmonary tuberculosis in children: a hospital based study. Indian J. of Community Health, 25 (1), 22–27.
Shubha, A. B., Sapna, H., Dinesh Rao, B. (2010). Tuberculosis lymphadenitis presenting a diagnostic dilemma – a case report. International J. of Dental clinics, 2 (2), 48–52.
Fontanilla, J.-M., Barnes, A., von Reyn, C. F. (2011). Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis. Clinical Infectious Diseases, 53 (6), 555–562. doi: 10.1093/cid/cir454
Bіlogortseva, O. І., Feshchenko, Yu. І. (2011). Epіdemіologіchna situatsіya shchodo tuberkul'ozu u dіtei ta pokazniki protituberkul'oznoі roboti sered dityachogo naselennya v Ukraіnі u 2010 rotsі. Ukraіns'kii pul'monologіchnii zhurnal, 4, 11–15.
Forssbohm, M., Zwahlen, M., Loddenkemper, R., Rieder, H. L. (2008). Demographic characteristics of patients with extrapulmonary tuberculosis in Germany. European Respiratory Journal, 31 (1), 99–105. doi: 10.1183/09031936.00020607
Tinsa, F., Essaddam, L., Fitouri, Z., Nouira, F., Douira, W. et. al. (2009). Extra-pulmonary tuberculosis in children: a study of 41 cases. La tunisie Medicale, 87 (10), 693–698.
Buonsenso, D., Serranti, D., Valentini, P. (2010). Management of central nervous system tuberculosis in children: light and shade. European Review for Medical and Pharmacological Sciences, 14 (10), 845–853.
Subinay, M., Kumar, D. A., Kumar, M. S. (2013). Tuberculous meningitis in children: a two years experience in a peripheral medical college of India. International journal of medical and applied sciences, 2, 34–46.
Christensen, A.-S. H., Andersen, Å. B., Thomsen, V. Ø., Andersen, P. H., Johansen, I. S. (2011). Tuberculous meningitis in Denmark: a review of 50 cases. BMC Infectious Diseases, 11 (1). doi: 10.1186/1471-2334-11-47
Principi, N., Esposito, S. (2012). Diagnosis and therapy of tuberculous meningitis in children. Tuberculosis, 92 (5), 377–383. doi: 10.1016/j.tube.2012.05.011
Nechaеva, O. B., Burylova, E. A. (2009). Epidemicheskaya situatsiya po tuberkulezu glaz v Sverdlovskoi oblasti. Problemy tuberkuleza i boleznei legkikh, 7, 14–19.
Copyright (c) 2016 Lidia Mykolyshyn, Zoriana Piskur
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.