Spectrum Of Adolescent Tuberculosis in a Tertiary Care Hospital at Shimla, North India.

Background: Tuberculosis amongst adolescents is distinct from both childhood and adult tuberculosis in terms of incidence, disease manifestations and response. These peculiarities are due to issues related to immunity, hormone imbalance, social interactions and psychology unique to this phase of life. Adolescent tuberculosis remains a less studied area in India. Aims: To study the spectrum of tuberculosis in adolescents. Methods: We analyzed demographic, clinical and paraclinical data from 477 adolescents (10-19 years of age) diagnosed to have Tuberculosis, who reported to the in the Department of paediatrics, Indira Gandhi Medical College, Shimla between the years 2010 and 2014. Results: The incidence of tuberculosis among hospital visiting adolescents was 0.8%.The incidence in females (1.00 %) was significantly more in comparison to males (0.63 %) with females having (OR1.60) 1.60 times more odds of suffering from Tuberculosis than males (p< 0.001). Isolated Pulmonary tuberculosis (PTB) was seen in 52% cases, extrapulmonary tuberculosis (EPTB) in 40 % and combined PTB with EPTB in 8 % cases. The most common forms of extrapulmonary tuberculosis were pleural effusion (25.6%) and central nervous system tuberculosis (24.7%). Infiltration (consolidation) was the most common chest x-ray finding (53.7 %). Conclusion: Pulmonary disease accounted for high proportion of tubercular cases. Among Extrapulmonary forms isolated pleural effusion and central nervous system tuberculosis were the most common closely followed by abdominal tuberculosis, while lymphadenitis was less common. The incidence among females was significantly high in comparison to males (P<.001).