Prevalence of the urinary tract tuberculosis in the structure of all forms and localizations of tuberculosis in children of preschool and primary school age

• Main Authors: A. R. Aroyan, A. V. Mordyk
• Format: Article
• Language: Russian
• Published: State Budget Educational Institute of Higher Professional Education, Rostov State Medical University, Ministry Health of Russian Federation 2020-12-01
• Series: Vestnik Urologii
• Subjects: tuberculosis; children; preschool age; primary school age; urinary tract tuberculosis; extrapulmonary tuberculosis; generalized tuberculosis
• Online Access: https://www.urovest.ru/jour/article/view/384

Introduction. Extrapulmonary tuberculosis is more difficult to diagnose than respiratory tuberculosis. However, late detection leads to disabling consequences. Children from 4 to 11 years old are at risk for tuberculosis due to increased communication skills. It seems relevant to isolate urinary tract tuberculosis (UTTB) in children of these age groups in the structure of all forms to improve its diagnosis.Purpose of the study. Isolation of urinary tract tuberculosis to determine the significance and improve the diagnosis of this localization of tuberculosis in the structure of all forms and localizations of tuberculosis in children of preschool and primary school age.Materials and methods. The cohort comparative study included 303 children aged 4 to 6 years and 306 children aged 7 to 11 years who had tuberculosis in the period from 2000 to 2018. The results were statistically processed using the Microsoft Office 2007 software package, Biostat 2009. Differences between the groups were determined using the Х2 test. The hypothesis of the absence of a statistically significant influence of the factor was rejected at p > 0.05.Results. Respiratory tuberculosis (RTB) was diagnosed in children of preschool and primary school age in most cases (94.7% and 89.9%; p < 0.05), bacteriological confirmation was found in 6.3% and 3.6% (p > 0.05) children in the compared age groups. Tuberculosis of the intrathoracic lymph nodes (TBILN) prevailed (85.7% and 75.3%; p < 0.05) in the structure of RTB. Primary tuberculosis complex (PTBC) was more often diagnosed in children of primary school age (23.3%) than in preschoolers (13.2%; p < 0.05). The registration frequency of isolated extrapulmonary forms of tuberculosis was 1.3% and 5.6% (p < 0.05), bacteriological confirmation of the diagnosis was 25,0% and 35.3% (p > 0.05). Most of the detected cases of isolated extrapulmonary tuberculosis accounted for UTTB - 50,0% and 64.7% (p > 0.05), all cases were confirmed bacteriologically. Generalization of the tuberculous process was noted in 4.0% and 4.6% of cases (p > 0.05). Most cases of generalized tuberculosis in children from 4 to 11 years old were associated with a combination of tuberculosis primary forms, mainly (TBILN) and in one case of PTBC, with UTTB (83.3% and 85.7%; p > 0.05). These cases of combinations were confirmed bacteriologically.Conclusion. Children of preschool and primary school age were diagnosed most often with TBILN. Isolated extrapulmonary tuberculosis was rare; UTTB predominated with frequent bacteriological confirmation. Isolated extrapulmonary tuberculosis was rare, UTTB of the predominated with frequent bacteriological confirmation. Generalization of tuberculosis in children 4-11 years old was rare; isolated forms of extrapulmonary tuberculosis were more often diagnosed. Most of the cases of combined localizations were due to a combination of TBILN and UTTB. UTTB was confirmed by the detection of M. tuberculosis in urine cultures. Physicians of primary health care and specialized services should be aware of the possibility of developing UTTB in children from 4 to 11 years old and search for the pathogen in patients with chronic UTIs and infected with M. tuberculosis.