Rohola Shirzadi 
, Mahsa Soti Khiabani , Zahra Golmoghani Ebrahimi , Ali Tarzamni , Mahmoud Khodabandeh *
, Mahsa Soti Khiabani , Zahra Golmoghani Ebrahimi , Ali Tarzamni , Mahmoud Khodabandeh *
Department of Pediatric Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (13 Views)
Introduction: Tuberculosis (TB) remains a major pediatric health challenge in hospital settings, with significant diagnostic and treatment difficulties. Pediatric TB outcomes are highly variable, with well-established determinants including age, nutritional status, HIV co-infection, and delayed or limited access to care. Methods: We conducted a retrospective cohort study of children hospitalized with TB in the Pediatric Infectious Diseases Ward, Children's Medical Center, Tehran, Iran, from January 2016 to December 2021. Data included demographics, clinical presentation, radiologic findings, diagnostic tests, treatment regimens, and outcomes. Not all diagnostic tests were performed in every patient; positivity rates were calculated only among patients who were tested for each diagnostic modality. Associations with in-hospital mortality were analyzed using Fisher's exact test. Results: Thirty patients were included (mean age 8.8 ± 3.8 years; 53.3% girls). Of these, 22 (73.3%) were Iranian and 8 (26.7%) were non-Iranian (migrant/refugee). Pulmonary TB was most common (66.7%). Cough (46.7%) was the most common presenting symptom, followed by fever (40.0%) and dyspnea (13.3%). Consolidation/infiltrate (33.3%) and pleural effusion (23.3%) were the main radiographic findings. Among diagnostic tests, the Tuberculin Skin Test (TST) was positive in 19/23 (82.6%), culture in 14/19 (73.7%), PCR in 18/26 (69.2%), and interferon-γ release assay (IGRA) in 5/19 (26.3%). Overall, 27/30 (90%) recovered, while 3/30 (10%) died; fatalities occurred exclusively in patients with central nervous system (CNS) TB or severe pleural disease. Mortality was not significantly associated with age, sex, residence, TB site, or nationality (all P > 0.05). Conclusion: Pediatric TB often presents with nonspecific symptoms, leading to delayed diagnosis. Among diagnostic tools, TST showed the highest positivity rate, but PCR and mycobacterial culture provided the most consistent and clinically relevant confirmation of pediatric TB, whereas IGRA showed limited utility in this cohort. Most children recovered with standard therapy, but mortality clustered in CNS and severe pleural TB. Strengthening early diagnosis and ensuring equitable access to care—especially for migrant children—remain priorities.
Keywords: Child, Hospitalization, Tuberculin test, Polymerase chain reaction, Treatment outcome, Mortality, Refugees
Type of Study: Original article |
Subject:
Infectious diseases and public health
Received: 2025/09/23 | Accepted: 2026/02/21
Received: 2025/09/23 | Accepted: 2026/02/21
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