The pattern of childhood tuberculosis at the Ethio Swedish-Children's Hospital

Abstract: Tuberculosis (TB) still remains a major public health problem in the developing world. Ninety five percent of the cases and 99% of deaths due to TB occur in the developing countries. TB is one of the major health problems in Ethiopia. The objective of the study is to outline the pattern of TB among Ethiopian children. Three hundred and seventy five children fulfilling the clinical criteria for TB were enrolled in the study at the ESCH, Addis Ababa, over a period of one year, from May 1993 to April 1994. Their ages ranged from one month to 14 years. The M:F ratio was 1.03:1 . Most children were from families with low socio-economic status, who lived in a one or two-roomed houses. More than five people live in a house in about 80% of the families. Symptom complex of TB and compatible X-ray were the two commonest findings followed by positive Mantoux test. Sputum examination for acid fast bacilli was done in 37 patients and was positive in 27% of them. Opacity was the commonest chest X-ray finding followed by infiltrations and hilar/paratracheal lymphadenopathy. There were nine patients with cavitary tuberculosis. Cervical lymph nodes were mostly affected (55.5%) followed by axillary nodes (24.0%). Thoracic vertebrae were common sites for spondylitis. Forty four and half percent had pulmonary TB, 27.5% had extra pulmonary TB, and 28% of the patients had two or more systems involved. Forty four percent of the patients were lost to follow up and 52.3% of the patients completed their treatment. Only three had signs of drug toxicity and one had treatment failure. Thirteen patients (3.5%) died at the hospital. The study showed that the lung is the most commonly affected organ, the commonest site of affection for extra pulmonary tuberculosis being the lymph nodes. Early diagnosis and close follow up are needed for better outcome in all cases of TB in children. [Ethiop. J. Health Dev. 1998;12(3):245-251