Treatment delay in childhood pleural tuberculosis and associated factors

BMC Infectious Diseases

Chao Han¹  Huai-Zheng Gong²  Mao-Shui Wang²  Chun-Fang Wang³  Jun-Li Wang³  Feng-Lian Yang⁴ 

[1] Department of Geriatrics, Shandong Mental Health Center, Jinan, China;Department of Lab Medicine, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China;Department of Lab Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China;School of Pharmacy, Youjiang Medical University for Nationalities, Baise, China;

关键词: Children;    Pleural tuberculosis;    Treatment;    Delay;    Risk factor;   

DOI  :  10.1186/s12879-020-05496-4

来源: Springer

【 摘 要 】

BackgroundDelay 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.MethodsBetween 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.ResultsA 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.ConclusionOur 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.

【 授权许可】

CC BY