Evolution of TB in BCG unimmunized children

2016 
Introduction: The severe TB forms after BCG vaccination refusal has become familiar in the child healthcare, thus the TB treatment has unpredictable outcomes. Aims and objectives: To evaluate the risk factors and the clinical features of TB in BCG unimmunized children and treatment efficacy. Methods: We examined a sample of 41 cases of TB in BCG unimmunized children and evaluated the risk factors of having TB, the methods used to confirm TB, the clinical evolution and the treatment efficacy. Results: The study sample included 19 boys (46%) and 22 girls (54%), 31 (76%) children being of risk age. Parent refusal of BCG immunization was found in 14 (34%) cases, followed by 6 (15%) children born in countries with no BCG in the vaccination schedule. 31 (75%) children were found in family or school TB outbreak. There were 29 (64%) cases diagnosed only by clinical and radiological data, and the Mantoux test. There were found 28 (60%) children with intrathoracic tuberculous lymphadenopathy, 7 (17%) of which were MDR-TB, and 1 (2%) HIV co-infected child. Furthermore, 6 (13%) adolescents were found with infiltrative pulmonary TB with pleural effusion and dissemination. Persistent febrile syndrome and rare dry cough outlined the clinical manifestations. The 1 st line drugs were used in 40 (91%) cases, while 2 (4%) children had the 2 nd line drugs. Half of the children needed additional antibiotics for the associated infections. 24 (59%) children underwent continuous ambulatory treatment, 14 (34%) were lost out of direct supervision, 2 (5%) finished treatment and 1 (2%) has died. Conclusion: BCG unimmunized children have a high social risk of making severe TB that is hard to confirm and has reserved treatment efficacy in 36 % of cases.
    • Correction
    • Source
    • Cite
    • Save
    • Machine Reading By IdeaReader
    0
    References
    0
    Citations
    NaN
    KQI
    []