Tuberculosis en pacientes pediátricos en el departamento del Atlántico, Colombia (2021– 2023)
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Fecha
2025
Autores
Tatis Geney, Steffany Isabel
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: La tuberculosis (TB) pediátrica continúa siendo un problema de salud pública relevante, especialmente en países en desarrollo, donde la desnutrición y las condiciones de vulnerabilidad social incrementan el riesgo de desenlaces desfavorables. Objetivo: Evaluar las características sociodemográficas, clínicas y paraclínicas y su impacto en los desenlaces del tratamiento en pacientes pediátricos diagnosticados con tuberculosis en el departamento del Atlántico entre 2021 y 2023.
Métodos: Se realizó un estudio analítico, retrospectivo y transversal basado en el registro departamental de tuberculosis del Atlántico (Colombia), entre 2021 y 2023. Se incluyeron pacientes pediátricos de 1 a 18 años con diagnóstico confirmado de TB. Se evaluaron variables sociodemográficas, clínicas, paraclínicas y terapéuticas. Se aplicaron pruebas estadísticas comparativas, curvas de Kaplan-Meier y modelos de regresión de Cox. Resultados: Se analizaron 83 pacientes, de los cuales 21,7 % fallecieron. El 59 % eran masculinos y la mediana de edad fue 15 años; los fallecidos fueron significativamente más jóvenes (10 años; p=0,045). La desnutrición fue más frecuente en fallecidos (33 % vs 14 %) y se asoció con mayor riesgo de mortalidad (HR=3,73; IC95 %: 1,19–11,7; p=0,024). La neoplasia se presentó únicamente en fallecidos (11 %; p=0,045). La sobrevida a 12 meses no difirió entre TB pulmonar y extrapulmonar (75,5 % vs 60 %; p=0,56). Los pacientes con prueba molecular positiva tuvieron mayor probabilidad de sobrevida (73,7 % vs 48,3 %; p=0,03).
Conclusiones: La desnutrición es un predictor independiente de mortalidad en TB pediátrica, mientras que la detección molecular temprana se asocia con mayor sobrevida. Estos hallazgos resaltan la necesidad de integrar programas de soporte nutricional y ampliar la cobertura de pruebas moleculares en el manejo de la TB infantil en contextos de alta vulnerabilidad.
Background: Pediatric tuberculosis (TB) remains a major public health challenge, particularly in low- and middle-income countries where malnutrition and social vulnerability increase the risk of poor outcomes. Objective: To evaluate the sociodemographic, clinical, and paraclinical characteristics and their impact on treatment outcomes in pediatric patients diagnosed with tuberculosis in the department of Atlántico, Colombia, between 2021 and 2023. Methods: We conducted an analytical, retrospective, cross-sectional study using the official TB registry from Atlántico, Colombia, between 2021 and 2023. Children and adolescents aged 1–18 years with confirmed TB were included. Sociodemographic, clinical, paraclinical, and therapeutic variables were assessed. Comparative statistical tests, Kaplan-Meier survival curves, and Cox regression models were applied. Results: A total of 83 patients were analyzed; 21.7 % died during follow-up. Overall, 59 % were male, with a median age of 15 years; deceased patients were significantly younger (10 years; p=0.045). Malnutrition was more frequent among deceased patients (33 % vs 14 %) and independently associated with mortality (HR=3.73; 95 %CI: 1.19–11.7; p=0.024). Neoplasia was exclusively observed in deceased patients (11 %; p=0.045). Twelve-month survival did not differ between pulmonary and extrapulmonary TB (75.5 % vs 60 %; p=0.56). Patients with positive molecular tests had higher survival probability (73.7 % vs 48.3 %; p=0.03). Conclusions: Malnutrition is an independent predictor of mortality in pediatric TB, while early molecular detection is associated with increased survival. These findings highlight the importance of strengthening nutritional support programs and expanding access to molecular diagnostics for pediatric TB in vulnerable settings.
Background: Pediatric tuberculosis (TB) remains a major public health challenge, particularly in low- and middle-income countries where malnutrition and social vulnerability increase the risk of poor outcomes. Objective: To evaluate the sociodemographic, clinical, and paraclinical characteristics and their impact on treatment outcomes in pediatric patients diagnosed with tuberculosis in the department of Atlántico, Colombia, between 2021 and 2023. Methods: We conducted an analytical, retrospective, cross-sectional study using the official TB registry from Atlántico, Colombia, between 2021 and 2023. Children and adolescents aged 1–18 years with confirmed TB were included. Sociodemographic, clinical, paraclinical, and therapeutic variables were assessed. Comparative statistical tests, Kaplan-Meier survival curves, and Cox regression models were applied. Results: A total of 83 patients were analyzed; 21.7 % died during follow-up. Overall, 59 % were male, with a median age of 15 years; deceased patients were significantly younger (10 years; p=0.045). Malnutrition was more frequent among deceased patients (33 % vs 14 %) and independently associated with mortality (HR=3.73; 95 %CI: 1.19–11.7; p=0.024). Neoplasia was exclusively observed in deceased patients (11 %; p=0.045). Twelve-month survival did not differ between pulmonary and extrapulmonary TB (75.5 % vs 60 %; p=0.56). Patients with positive molecular tests had higher survival probability (73.7 % vs 48.3 %; p=0.03). Conclusions: Malnutrition is an independent predictor of mortality in pediatric TB, while early molecular detection is associated with increased survival. These findings highlight the importance of strengthening nutritional support programs and expanding access to molecular diagnostics for pediatric TB in vulnerable settings.
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Tuberculosis Pediátrica, Desnutrición, Análisis de Supervivencia, Técnicas de Diagnóstico Molecular, Factores de Riesgo