1. Dr. Bipul Kumar Das (PGT) Dr. Kumud Pathak, M.D. Dr. P. Biswanath, A sso. Professor, Dept. of Paediatrics AMCH A Clinical Study of Tuberculosis in Children with special reference to Gastric Aspirate

2. Introduction Tuberculosis - one of the most common diseases in the world with different names. Diagnosis difficult in children. 1.5 Million New Cases every year. 130,000 Deaths Each Year.

3. Different Diagnostic Modalities – - Clinical Signs & symptoms - Mantoux Test - Chest X-Ray - BAL & Gastric Aspirate for AFB smear - Culture Techniques - Serodiagnosis - Polymerase Chain Reaction Gastric Aspirate Study for direct smear for AFB and culture is a valuable test for the diagnosis of Tuberculosis in Children

4. Aims and Objectives Clinical study of Tuberculosis in Hospitalized children from age 1 – 12 years. To see the positivity of Gastric Aspirate for AFB in Tuberculosis.

5. Inclusion Criteria Provisionally diagnosed cases of Tuberculosis in Age Group of 1 -12 Years (as per WHO guidelines). Cases which were diagnosed with Pulmonary or Disseminated Tuberculosis.

6. Children below 1 year Children above 12 Year Exclusion Criteria

7. Materials & Methods Study Centre – Department of Paediatrics, AMCH Morning sample Gastric Aspirate of Probable cases of Pulmonary & Disseminated Tuberculosis. Sample collection for 3 consecutive days.. Smear Examination by Ziehl Neelsen staining method. Statistical Analysis – Student t test.

9. Results & Observations

10. Age group in Years Percentages 34.62% 17.94% 26.92% 20.52%

11. 58.97%41.03%

12. Percentages Nutritional Grade 20.51% 17.94% 16.66% 24.35% 20.51% Normal Grade I Grade II Grade III Grade IV

13. 6.41%5.12% 19.23% 44.87% 24.35% Socioeconomic Status Percentages (%)

14. 51.28% 37.17% 11.53%

15. 80.77% 19.23%

16. 48.71% 51.28%

17. Mantoux Reactivity with Nutritional Status Nutritional Status Percentages

18. 72.00%28.00%

19. 28.88% 71.12%

20. 47.05% 23.07% 16.67% 12.50% Age Group (in years) Percentage (%)

21. 28.57% 27.27% Percentage (%) SEX

22. Author with Year Age GroupTotal No. of Cases No. of AFB Positive cases % of Positive cases Abadco et al (1992) Mean Age 2.5 Years 201050.00 Somu et al (1995) 7 months to 2 years 501632.00 Pomputius et al (1997) Not Mentioned 8450.00 Lobato et al (1998) < 2 Years803341.00 Singh et al (2000) 6 months to 14 Years 581017.20 Gomez et al (2000) Not Mentioned 461532.60 Guillermo et al (2001) Mean Age 6.8 Years 1355037.00 Zar et al (2006) 1 Month to 5 Years 2504016.00 Present Study (2006) 1- 12 Years451328.89

23. Conclusion Tuberculosis more common in < 6 years of age. Poor socioeconomic status and malnutrition have Definite relation. Mantoux test is Positive in almost half of the patients.

24. AFB positive in 28.89% children with Pulmonary Tuberculosis in Gastric Aspirate. Gastric Aspirate for isolation of Tubercle Bacilli should be tried in every case as far as possible, as demonstration of AFB is the Gold Standard for diagnosis of Tuberculosis.