Abstract Ref Number = APCP231
CLINICAL SPECTRUM OF ADOLESCENT TUBERCULOSIS ADMITTED TO THE TERTIARY HOSPITAL IN WEST JAVA - THE HIDDEN DANGER OF A NEGLECTED SUBPOPULATION
I Wayan Andrew Handisurya,Sri Sudarwati,Heda Melinda Nataprawira
Department of Child Health Universitas Padjadjaran Hasan Sadikin General Hospital Bandung Indonesia
Background : Tuberculosis (TB) is a global public health problem mainly affecting developing countries, such as Indonesia. Although adolescents are part of pediatric age group, they may have the characteristics of adult-type TB. Limited data concerning this subpopulation may interfere with the management needed. The aim of our study is to identify the clinical spectrum of adolescent TB admitted to the tertiary referral hospital in West Java, the most populous province in Indonesia.
Material : This was a retrospective, cross-sectional study from medical charts of adolescents aged 10 to 18 years old hospitalized with ICD-10 codes of A15–A19 in Hasan Sadikin General Hospital between August 2016 and December 2017. Cases admitted to Internal Medicine or having incomplete charts were excluded.
Results : Fifty-three cases were included out of 135 cases identified. We excluded 57 and 25 cases in particular due to Internal Medicine admission and incomplete charts. Male was more common compared to female (53% vs. 47%). Majority of the subjects were in early adolescent (n=40, 75%) with the median age was 13 years. Nearly half of the cases (n=22, 42%) had isolated extrapulmonary TB of neurologic involvement. The most common presenting symptom was a decrease in body weight (n=34, 62%). Contact source was identified in only 20 (38%) cases. While more than half of the cases had suggestive chest radiography (n=36, 68%), bacteriological confirmation done using acid-fast stain and GeneXpert was found in only 8 (15%) and 12 (23%) cases, respectively. Five (9.4%) cases were Multidrug Resistant-Tuberculosis (MDR-TB). Antituberculosis drug-induced hepatotoxicity (ADIH) was the complication in 9 (17%) cases. No associations were found between age groups and TB types (p=0.341), bacteriological confirmation (p=0.061), ADIH (p=0.899) or mortality (p=0.800).
Conclusions : Adolescents with TB may show signs of severe, multibacillary TB usually found in adults. MDR-TB is a serious threat found in adolescent subpopulation.
Keywords: tuberculosis multidrug resistant clinical spectrum adolescent