Factors associated with pulmonary TB in malnourished children admitted to rehabilitation centres

OBJECTIVES Primary objective of the study was to identify TB-associated factors in admitted malnourished children at malnutrition treatment centres, Rajasthan, India. DESIGN A nested case-control study was conducted. Clinical and demographic data were analysed. Crude and adjusted odds ratios were calculated. RESULTS The study included 39 confirmed TB cases and 512 controls. A total of 20 clinical factors were analysed. Bivariate analysis identified three statistically significantly associated factors. These were 1) cough duration of ≥2 weeks (odds ratio [OR] = 5.4; 95% confidence interval [CI]: 2.5–11.6), 2) fever duration of ≥2 weeks (OR = 3.3; 95% CI: 1.4–7.7), and 3) Mantoux test ≥ 5 mm (OR = 4.4; 95% CI: 1.4–14.2). Multivariate regression analysis revealed that 1) cough duration of ≥2 weeks (adjusted odds ratio [AOR] = 4.2; 95% CI: 1.5–11.7) and 2) hepatomegaly (AOR = 2.4; 95% CI: 1.01–5.5) were independently and significantly associated with TB. CONCLUSION Study findings align with paediatric TB diagnostic criteria, which emphasise persistent cough ≥2 weeks as an important criterion of presumptive TB. However, hepatomegaly came out as a new, independently significant associated factor. A study with large number of cases may be undertaken to validate the association of hepatomegaly.