APPLYING A 2X STRATEGY FOR DETECTING ACTIVE TUBERCULOSIS IN CHILDREN FROM VIETNAM NATIONAL CHILDREN'S HOSPITAL IN 2022

Tóm tắt

The study was conducted to describe the distribution of active tuberculosis through the 2X strategy in children at Vietnam National Children’s Hospital in 2022. Materials and methods: We run a randomized trial on children under the age of 16 to determine the changing outcomes when applying the 2X screening model. Children have one of the following symptoms suspected of tuberculosis: cough, fever for more than 2 weeks, night sweats, weight loss/no weight gain, reduced activities for more than 2 weeks, brain/meningeal syndrome, or previous exposure to tuberculosis cases in the past 24 months. Through screening 6515 patients using the 2X screening method and clinical diagnosis, we had 40 patients diagnosed with tuberculosis, of which pulmonary tuberculosis: 32 patients, meningeal tuberculosis 9 patients, and 5 patients with multiorgan tuberculosis. The detection rate increased from 0.5% (the rate of natural tuberculosis) to 0.61% (40/6515). In pulmonary and pleural tuberculosis: the most common clinical symptoms are fever (100%), weight loss (68.8%), night sweats (43.8%), productive cough (46 .9%), chest pain (15.6%), difficulty breathing (6.3%). Lung lesions: parenchymal infiltration (65.6%), pleural effusion (34.4%), and consolidation (21.9%). Less common: nodules, miliary tuberculosis, tuberculous caverns, and inflammation of the interlobular septa. Lung CT specifically detects hilar lymph node damage at a rate of up to 57.1%, much higher than a chest X-ray. In the meningeal tuberculosis group: common clinical manifestations are fever (100%), headache/irritability (89%), meningeal syndrome (67%)