Treatment delay in childhood pleural tuberculosis and associated factors
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RESEARCH ARTICLE
Open Access
Treatment delay in childhood pleural tuberculosis and associated factors Huai-Zheng Gong1, Chao Han2, Feng-Lian Yang3, Chun-Fang Wang4, Jun-Li Wang4* and Mao-Shui Wang1*
Abstract Background: Delay in diagnosis and treatment worsens the disease and clinical outcomes, which further enhances the transmission of tuberculosis (TB) in the community. Therefore, this study aims to assess treatment delay and its associated factors among childhood pleural TB patients in China. Methods: Between January 2006 and December 2019, consecutive patients aged ≤15 years with definite or possible pleural TB were included for analysis. Treatment delay duration was defined as the time interval from the onset of symptoms to treatment initiation and was stratified into two categories: < 30 days, ≥30 days (median delay day is 30 days). The electronic medical records of children were reviewed to obtain demographic characteristics, clinical characteristics, laboratory examinations, and radiographic findings. Univariate and multivariate logistic regressions were used to explore the factors associated with treatment delay in patients. Results: A total of 154 children with pleural TB were included, with a mean age of 12.4 ± 3.3 years. The median treatment delay was 30 days (interquartile range, 10–60 days) and 51.3% (n = 79) of patients underwent a treatment delay. Multivariate analysis revealed that heart rate (≤92 beats/min, age-adjusted OR = 2.503, 95% CI: 1.215, 5.155) and coefficient of variation of red cell distribution width (RDW-CV, ≥12.9%, age-adjusted OR = 4.705, 95% CI: 2.048, 10.811) were significant risk factors for treatment delays in childhood pleural TB. Conclusion: Our findings suggested that a significant treatment delay occurs among children with pleural TB in China. Patients with a low heart rate or a high RDW-CV experienced delays in the initiation of anti-TB therapy. Therefore, well awareness of the associations between clinical characteristics and treatment delay may improve the management of children with pleural TB and enable us to develop preventive strategies to reduce the treatment delay. Keywords: Children, Pleural tuberculosis, Treatment, Delay, Risk factor
Background According to the World Health Organization (WHO), 10.0 million people fell ill with tuberculosis (TB), 1.2 million TB deaths occurred among HIV-negative people and 251,000 TB deaths occurred among HIV-positive people in 2018 [1]. In children, although Bacille * Correspondence: [email protected]; [email protected] 4 Department of Lab Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China 1 Department of Lab Medicine, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China Full list of author information is available at the end of the article
Calmette–Guérin (BCG) vaccination confers protection, children still account for 11% of total TB cases [1]. Pleural TB is thought to be a common form of TB disease in children, with an approxi
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