{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:01:37Z","timestamp":1790190097620,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Tianshan Talent Training Program of Xinjiang Uygur Autonomous Region","award":["2022TSYCCX0105"],"award-info":[{"award-number":["2022TSYCCX0105"]}]},{"name":"Key R&D Program of Xinjiang","award":["2024B03021-2"],"award-info":[{"award-number":["2024B03021-2"]}]},{"name":"the Training Plan for High-level Public Health Technical Talents","award":["No. 2022-3-041"],"award-info":[{"award-number":["No. 2022-3-041"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Background: Tuberculosis (TB) remains a major public health challenge among children and adolescents in high-burden countries. Xinjiang, the region with the highest TB incidence in China, has limited data on the clinical and epidemiological characteristics of pediatric TB. Methods: We conducted a retrospective cross-sectional study of children and adolescents (\u226417 years) hospitalized with TB at a regional referral hospital in Xinjiang between 1 January 2020 and 31 December 2022. Demographic, clinical, and laboratory data were analyzed, and risk factors for extrapulmonary TB (EPTB) and severe TB were assessed. Results: A total of 253 patients were included, of whom 54.9% (139\/253) had pulmonary TB (PTB) and 45.1% (114\/253) had EPTB. EPTB was more common among children &lt;5 years (78.9%, 15\/19). The predominant clinical symptoms were fever (55.7%, 141\/253), cough (66.8%, 169\/253), fatigue (60.9%, 154\/253), and night sweats (51.8%, 131\/253). Tuberculous meningitis (TBM) was the most frequent EPTB manifestation (40.4%, 46\/114). Younger age, rural residence, and absence of BCG vaccination were associated with a higher risk of EPTB. Laboratory findings showed high positivity rates for tuberculin skin test (96.1%, 99\/103) and interferon-\u03b3 release assay (84.5%, 196\/232), but low yields for smear microscopy and Xpert MTB\/RIF, especially in EPTB cases. Conclusions: Pediatric TB in Xinjiang is characterized by a high burden of EPTB, particularly TBM in young children. Strengthening early diagnosis and improving access to effective diagnostic tools are essential to reduce morbidity and improve outcomes in this vulnerable population.<\/jats:p>","DOI":"10.3390\/tropicalmed10100293","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:17:02Z","timestamp":1760617022000},"page":"293","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Characteristics and Risk Factors of Tuberculosis in Children and Adolescents in Xinjiang, China: A Retrospective Analysis"],"prefix":"10.3390","volume":"10","author":[{"given":"Tao","family":"Xin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The Infectious Disease Hospital of Xinjiang Uygur Autonomous Region, The Sixth People\u2019s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8519-4601","authenticated-orcid":false,"given":"Gaofeng","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Science and Education, Xinjiang Institute of Pediatrics, Xinjiang Hospital of Beijing Children\u2019s Hospital, Children\u2019s Hospital of Xinjiang Uygur Autonomous Region, The Seventh People\u2019s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830054, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangbutaer","family":"Entemake","sequence":"additional","affiliation":[{"name":"Department of Science and Education, Xinjiang Institute of Pediatrics, Xinjiang Hospital of Beijing Children\u2019s Hospital, Children\u2019s Hospital of Xinjiang Uygur Autonomous Region, The Seventh People\u2019s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830054, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beiming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Science and Education, Xinjiang Institute of Pediatrics, Xinjiang Hospital of Beijing Children\u2019s Hospital, Children\u2019s Hospital of Xinjiang Uygur Autonomous Region, The Seventh People\u2019s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830054, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1832-265X","authenticated-orcid":false,"given":"Weiwei","family":"Jiao","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Laboratory of Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9153-2237","authenticated-orcid":false,"given":"Qifeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Science and Education, Xinjiang Institute of Pediatrics, Xinjiang Hospital of Beijing Children\u2019s Hospital, Children\u2019s Hospital of Xinjiang Uygur Autonomous Region, The Seventh People\u2019s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830054, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). Global Tuberculosis Report 2024, World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"An, Y., Teo, A.K.J., Huot, C.Y., Tieng, S., Khun, K.E., Pheng, S.H., Leng, C., Deng, S., Song, N., and Nonaka, D. (2023). Barriers to childhood tuberculosis case detection and management in Cambodia: The perspectives of healthcare providers and caregivers. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08044-y"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ukoaka, B.M., Daniel, F.M., Wagwula, P.M., Ahmed, M.M., Udam, N.G., Okesanya, O.J., Babalola, A., Wali, T.A., Afolabi, S., and Udoh, R.A. (2024). Prevalence, clinical characteristics, and treatment outcomes of childhood tuberculosis in Nigeria: A systematic review and meta-analysis. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-10321-3"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tong, J., Gao, M., Chen, Y., and Wang, J. (2023). A case report about a child with drug-resistant tuberculous meningitis. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-07990-x"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1002\/ped4.12342","article-title":"Bacteremia tuberculosis among HIV-negative children in China","volume":"6","author":"Chu","year":"2022","journal-title":"Pediatr. Investig."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e36242","DOI":"10.2196\/36242","article-title":"Unbalanced Risk of Pulmonary Tuberculosis in China at the Subnational Scale: Spatiotemporal Analysis","volume":"8","author":"Hu","year":"2022","journal-title":"JMIR Public Health Surveill."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"663","DOI":"10.5588\/ijtld.14.0879","article-title":"Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005\u20132010","volume":"19","author":"Moore","year":"2015","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1433","DOI":"10.1542\/peds.2011-3742","article-title":"Pediatric tuberculosis at Beijing Children\u2019s Hospital: 2002\u20132010","volume":"130","author":"Wu","year":"2012","journal-title":"Pediatrics"},{"key":"ref_9","unstructured":"National Health and Family Planning Commission of the People\u2019s Republic of China (2018). Diagnosis for Pulmonary tuberculosis (WS288-2017). Electr. J. Emerg. Infect. Dis., 3, 59\u201361."},{"key":"ref_10","unstructured":"National Health and Family Planning Commission of the People\u2019s Republic of China (2018). Classification of tuberculosis (WS196-2017). Chin J Infect Control., 17, 367\u2013368."},{"key":"ref_11","unstructured":"Pediatric Tuberculosis Specialty Committees of Chinese Society of Tuberculosis, Chinese Medical Association (2022). Expert consensus on the diagnosis of tuberculous meningitis in children. Chin. J. Appl. Clin. Pediatr., 37, 497\u2013501."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/INF.0b013e318243e27b","article-title":"A proposed comprehensive classification of tuberculosis disease severity in children","volume":"31","author":"Wiseman","year":"2012","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1097\/INF.0000000000003584","article-title":"Age-specific Clinical Presentation and Risk Factors for Extrapulmonary Tuberculosis Disease in Children","volume":"41","author":"Dubois","year":"2022","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_14","first-page":"1142","article-title":"Epidemiological characteristics of pulmonary tuberculosis in children aged 0\u201314 years in Xinjiang, 2010\u20132019","volume":"36","author":"Dong","year":"2021","journal-title":"Dis. Surveill."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.1080\/22221751.2022.2112912","article-title":"High proportion of tuberculosis transmission among social contacts in rural China: A 12-year prospective population-based genomic epidemiological study","volume":"11","author":"Li","year":"2022","journal-title":"Emerg. Microbes Infect."},{"key":"ref_16","first-page":"450","article-title":"Analysis of factors affecting the epidemiology of tuberculosis in China","volume":"9","author":"Liu","year":"2005","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_17","first-page":"100158","article-title":"Current Status of Tertiary Healthcare Services and Its Accessibility in Rural and Remote Australia: A Systematic Review","volume":"11","author":"Baazeem","year":"2024","journal-title":"Health Sci. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"fmaa042","DOI":"10.1093\/tropej\/fmaa042","article-title":"Treatment Outcomes of Childhood Tuberculosis in Three Districts of Balochistan, Pakistan: Findings from a Retrospective Cohort Study","volume":"67","author":"Abdullah","year":"2021","journal-title":"J. Trop. Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Lemaire, J.F., Cohn, J., Kakayeva, S., Tchounga, B., Ekou\u00e9vi, P.F., Ilunga, V.K., Yara, D.O., Lanje, S., Bhamu, Y., and Haule, L. (2024). Improving TB detection among children in routine clinical care through intensified case finding in facility-based child health entry points and decentralized management: A before-and-after study in Nine Sub-Saharan African Countries. PLoS Glob. Public Health, 4.","DOI":"10.1371\/journal.pgph.0002865"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Horton, K.C., MacPherson, P., Houben, R.M.G.J., White, R.G., and Corbett, E.L. (2016). Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002119"},{"key":"ref_21","first-page":"78","article-title":"Epidemic trend of tuberculosis in adolescents in China","volume":"45","author":"Shang","year":"2024","journal-title":"Chin. J. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Berry, K.M., Rodriguez, C.A., Berhanu, R.H., Ismail, N., Mvusi, L., Long, L., and Evans, D. (2019). Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7257-4"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Omongot, S., Muttamba, W., Najjingo, I., Baluku, J.B., Kitaka, S., Turyahabwe, S., and Kirenga, B. (2024). Strategies to resolve the gap in adolescent tuberculosis care at four health facilities in Uganda: The teenager\u2019s TB pilot project. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0286894"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/jgid.jgid_229_20","article-title":"Adolescent Females are More Susceptible than Males for Tuberculosis","volume":"13","author":"Thakur","year":"2021","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Neyrolles, O., and Quintana-Murci, L. (2009). Sexual inequality in tuberculosis. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000199"},{"key":"ref_26","first-page":"132","article-title":"Status of vitamin D levels in Karamay residents of Xinjiang province","volume":"12","author":"Wang","year":"2019","journal-title":"Chin. J. Osteoporos. Bone Min. Res."},{"key":"ref_27","first-page":"697","article-title":"Survey on the health status of 1008 junior high school students in Changji City, Xinjiang","volume":"35","author":"Wu","year":"2019","journal-title":"J. Med. Pest Control"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"457","DOI":"10.3201\/eid2503.180572","article-title":"Epidemiology of Extrapulmonary Tuberculosis among Inpatients, China, 2008\u20132017","volume":"25","author":"Pang","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1080\/22221751.2022.2054367","article-title":"Epidemiology of extrapulmonary tuberculosis among pediatric inpatients in mainland China: A descriptive, multicenter study","volume":"11","author":"Chu","year":"2022","journal-title":"Emerg. Microbes Infect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e36779","DOI":"10.1016\/j.heliyon.2024.e36779","article-title":"Comparative analysis of pediatric pulmonary and extrapulmonary tuberculosis: A single-center retrospective cohort study in Syria","volume":"10","author":"Hamdar","year":"2024","journal-title":"Heliyon"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"56","DOI":"10.22159\/ajpcr.2023.v16i11.49538","article-title":"Clinical profile and outcome of pediatric tuberculosis in a tertiary care setting in central India","volume":"16","author":"Tripathi","year":"2023","journal-title":"Asian J. Pharm. Clin. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/jgh3.12245","article-title":"Abdominal tuberculosis in children: A real-world experience of 218 cases from an endemic region","volume":"4","author":"Lal","year":"2020","journal-title":"JGH Open"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2894","DOI":"10.1016\/j.vaccine.2005.12.044","article-title":"Protective effect of Bacillus Calmette-Guerin (BCG) vaccination in children with extra-pulmonary tuberculosis, but not the pulmonary disease. A case-control study in Rosario, Argentina","volume":"24","author":"Bonifachich","year":"2006","journal-title":"Vaccine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ijid.2022.04.023","article-title":"Effectiveness of Bacillus Calmette-Gu\u00e9rin vaccination against severe childhood tuberculosis in China: A case-based, multicenter retrospective study","volume":"121","author":"Liao","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"268","DOI":"10.4103\/0366-6999.223860","article-title":"Interferon-Gamma Release Assay is Not Appropriate for the Diagnosis of Active Tuberculosis in High-Burden Tuberculosis Settings: A Retrospective Multicenter Investigation","volume":"131","author":"Kang","year":"2018","journal-title":"Chin. Med. J."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/10\/293\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:01:11Z","timestamp":1761058871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/10\/293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["tropicalmed10100293"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10100293","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]}}}