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India has one of the highest tuberculosis (TB) burdens globally. However, few studies have focused on TB in young children, a vulnerable population, where lack of early diagnosis results in poor outcomes.<jats:italic>Methods<\/jats:italic>. Young children (\u22645 years) with suspected TB were prospectively enrolled at a tertiary hospital in Pune, India. Detailed clinical evaluation, HIV testing, mycobacterial cultures, and drug susceptibility testing were performed.<jats:italic>Results<\/jats:italic>. 223 children with suspected TB were enrolled. The median age was 31 months, 46% were female, 86% had received BCG, 57% were malnourished, and 10% were HIV positive. 12% had TB disease (definite or probable), 35% did not have TB, while TB could not be ruled out in 53%. Extrapulmonary disease was noted in 46%, which was predominantly meningeal. Tuberculin skin test (TST) was positive in 20% of children with TB. Four of 7 (57%) children with culture-confirmed TB harbored drug-resistant (DR) strains of whom 2 (50%) were multi-DR (MDR). In adjusted analyses, HIV infection, positive TST, and exposure to household smoke were found to be significantly associated with children with TB (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>P<\/mml:mi><mml:mo>\u2264<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:math>). Mortality (at 1 year) was 3 of 26 (12%) and 1 of 79 (1%), respectively, in children with TB and those without TB (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mi>\u00a0<\/mml:mi><mml:mn>0.05<\/mml:mn><\/mml:math>).<jats:italic>Conclusions<\/jats:italic>. Diagnosis of TB is challenging in young children, with high rates of extra-pulmonary and meningeal disease. While the data on DR-TB are limited by the small sample size, they are however concerning, and additional studies are needed to more accurately define the prevalence of DR strains in this vulnerable population.<\/jats:p>","DOI":"10.1155\/2013\/783698","type":"journal-article","created":{"date-parts":[[2013,12,10]],"date-time":"2013-12-10T16:02:27Z","timestamp":1386691347000},"page":"1-7","source":"Crossref","is-referenced-by-count":48,"title":["Pediatric Tuberculosis in Young Children in India: A Prospective Study"],"prefix":"10.1155","volume":"2013","author":[{"given":"Sanjay K.","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II, Room 1.09, Baltimore, MD 21287, USA"},{"name":"Center for Tuberculosis Research, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II, Room 1.09, Baltimore, MD 21287, USA"},{"name":"Center for Infection and Inflammation Imaging 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