Risk Factors of Tuberculosis in Children

Objective: To determine the frequency of known risk factors in confirmed cases of tuberculosis in children. Study Design: Cross sectional study Methodology: Children between 2 and 144 months with confirmed tuberculosis were enrolled in the study from outpatient and inpatient departments. Detailed information was taken regarding, history of contact, history of measles or whooping cough, house hold size, people sleeping in a room, socioeconomic and education status of parents, history of steroid use and urban rural dwelling. Patients were examined for BCG scar and nutritional status. Place and Duration: It was done at the Children Hospital Pakistan Institute of Medical Sciences, Islamabad from August 2006 to May 2007. Materials and Methods: Children between 2 and 144 months with confirmed tuberculosis were enrolled in the study from outpatient and inpatient departments. Detailed information was taken regarding, history of contact, history of measles or whooping cough, house hold size, people sleeping in a room, socioeconomic and education status of parents, history of steroid use and urban rural dwelling. Patients were examined for BCG scar and nutritional status. Results: A total of 200 patients were evaluated. The mean age was 80 months, 160 (80%) patients had history of contact with TB case and 129 (69.5%) had no BCG scar. Illiteracy was found in 133 (66.5%) mothers and 73 (36.5%) fathers. One hundred and twenty three (61.5%) patients were residents of rural area and 102 (51.0%) belonged to poor background (income Rs. 3000/month). One hundred three (51.5%) patients belonged to families where 5 or more people live in one room. Only 1% of patients belong to such families where 2 persons live in one room. One hundred (50%) children had grade III malnutrition, 48 (24.0%) had grade II malnutrition while 30 (15.0%) had grade I malnutrition. Out of total 200 cases, 27 (13.5%) had history of long term use of steroids, 86 (43.0%) had history of measles in near past while there was no history of whooping cough in any of patients. Conclusion: Adult with TB disease spread TB to children. Family education especially the maternal education and vaccination with BCG are the two most important factors in preventing tuberculosis in children. Malnutrition, measles and steroid therapy are three important risk factors for development of tuberculosis in children.