Clinical Characteristics and Risk Factors of Tuberculosis in Children and Adolescents in Xinjiang, China: A Retrospective Analysis

Background: Tuberculosis (TB) continues to be a significant public health concern among children and adolescents in high-burden countries, including China. However, there is a paucity of literature concerning the clinical features and epidemiological characteristics of childhood TB in Xinjiang, the region with the highest TB burden in China. Methods: A retrospective analysis was conducted of children and adolescents aged 0-17 years who were hospitalized with TB between January 2020 and December 2022. A comprehensive analysis of demographic, clinical and laboratory data on different types of TB was conducted, and risk factors for extrapulmonary tuberculosis (EPTB) and severe TB were explored. Results: Among the 253 children and adolescents, 55.3% had pulmonary TB (PTB) and 45.1% had EPTB. The younger children (0-5 years) were more affected by EPTB (78.3%). The most prevalent clinical symptoms were fever (82.2%), cough (79.4%), fatigue (66.4%), and night sweats (52.6%). Tuberculous meningitis (TBM) was the predominant form of EPTB, accounting for 40.4% of cases. Younger age and rural residence were significant risk factors for both EPTB and severe TB. Laboratory results demonstrated high positivity rates for tuberculin skin tests (96.1%) and interferon-γ release assays (84.5%) in all patients, with lower rates of positive smear microscopy and GeneXpert results in EPTB cases. Conclusion: The epidemiology of childhood TB in Xinjiang is characterized by a high incidence of EPTB, with a particularly high prevalence of TBM among younger children. The improvement of early diagnosis of TB in children and adolescents is of critical importance for the enhancement of disease outcomes.