Trends in incidence of extrapulmonary tuberculosis in children in the Czech Republic in the past 35 years.

Abstract

Objective: Extrapulmonary tuberculosis (EPTB) in children globally represents a proportion of all cases of tuberculosis, reaching 20% according to published reports. Children are at a higher risk for disseminated TB and extrapulmonary forms. The most prevalent clinical presentations of EPTB in children worldwide are peripheral lymphadenitis and osteoarticular TB. Peritoneal, urogenital, or meningeal tuberculosis is less frequent, and their diagnosis is often difficult. The aim of the study was the determination of EPTB incidence in children in a low-prevalence region over 35 years.

Methods: Descriptive retrospective study of the incidence of EPTB in children and adolescents (aged 0-18 years) in the Czech Republic in the years 1987-2021 as reported in the tuberculosis register.

Results: Total amount of EPTB cases was 95. The most prevalent form was extrathoracic lymph node TB. The median age was 10 years. Most patients (84%) were Czechs. None of them died. The ratio of pulmonary and extrapulmonary TB was 79.8% to 20.2%.

Conclusion: The low incidence of EPTB in Czech children is congruent with a low incidence of TB in the Czech Republic. Our study confirms that the most frequent form of EPTB is peripheral lymph node TB. Our study did not prove a significant change in the trend of EPTB after the cessation of the mandatory Bacillus Calmette-Guerin (BCG) vaccination programme.