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

<sec><title>OBJECTIVES</title>Primary objective of the study was to identify TB-associated factors in admitted malnourished children at malnutrition treatment centres, Rajasthan, India.</sec><sec><title>DESIGN</title>A nested case-control study was conducted. Clinical and demographic data were analysed. Crude and adjusted odds ratios were calculated.</sec><sec><title>RESULTS</title>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) <i>cough duration of ≥2 weeks</i> (odds ratio [OR] = 5.4; 95% confidence interval [CI]: 2.5-11.6), 2) <i>fever duration of ≥2 weeks</i> (OR = 3.3; 95% CI: 1.4-7.7), and 3) <i>Mantoux test ≥ 5 mm</i> (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) <i>hepatomegaly</i> (AOR = 2.4; 95% CI: 1.01-5.5) were independently and significantly associated with TB.</sec><sec><title>CONCLUSION</title>Study findings align with paediatric TB diagnostic criteria, which emphasise persistent cough ≥2 weeks as an important criterion of presumptive TB. However, <i>hepatomegaly</i> 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.</sec>.