<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032019000200077</article-id>
<article-id pub-id-type="doi">10.31698/ped.46022019002</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tuberculosis: Factores de riesgo asociados a mortalidad en pacientes &#8804;19 años hospitalizados en el Instituto de Medicina Tropical]]></article-title>
<article-title xml:lang="en"><![CDATA[Tuberculosis: Risk factors associated with mortality in patients &#8804;19 years hospitalized at the Institute of Tropical Medicine]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez de Cuellar]]></surname>
<given-names><![CDATA[Celia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lovera]]></surname>
<given-names><![CDATA[Dolores]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gatti]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ojeda]]></surname>
<given-names><![CDATA[Limpia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Apodaca]]></surname>
<given-names><![CDATA[Silvio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zarate C]]></surname>
<given-names><![CDATA[Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arbo]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Medicina Tropical  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<volume>46</volume>
<numero>2</numero>
<fpage>77</fpage>
<lpage>81</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032019000200077&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032019000200077&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032019000200077&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La Organización Mundial de la Salud estima que anualmente ocurren 10 millones de casos incidentes de Tuberculosis (TB) en el mundo, de los cuales 10% ocurren en niños &lt;15 años. Las dificultades en el acceso a los establecimientos de salud y el retraso en el diagnóstico y tratamiento apropiados incrementan la mortalidad en el niño.  Objetivos:  analizar las características clínicas, laboratoriales y los factores asociados a mortalidad en &lt;19 años en pacientes hospitalizados por TB en Instituto de Medicina Tropical.  Metodología:  estudio observacional descriptivo, retrospectivo. Se incluyeron pacientes con diagnóstico de tuberculosis, hospitalizados, durante los años 2010 a 2018. Los datos fueron obtenidos de base de datos del Departamento de Epidemiología. Las variables incluidas fueron datos demográficos, formas de presentación, diagnóstico, tratamiento y factores asociados a la mortalidad. Se realizó análisis descriptivo y analítico. Se considero error alfa &lt; 5%.  Resultados:  Se identificaron 98 pacientes (pts) &#8804;19 años, con edad media de 9,3±6,3 años, 65,3% de sexo masculino. El 34,6% con infección por Virus de la inmunodeficiencia humana, y el 23,4% (23/98) con desnutrición. El 42,4% procedían de poblaciones con &lt;100.000 hab y el 23,4% pertenecían a pueblos originarios. El 19,4% (19/98) fallecieron. La mortalidad se asoció a vivienda en poblaciones con &lt;100.000 habitantes (33,3% vs 8,9%, p=0,02. RR=2,3. IC 1,1 - 5,0) y a la forma de TB meníngea (46,2% vs 15,3%, p&lt;0,01. RR= 3,0; IC 1,4 - 6,5).  Conclusiones:  La TB predominó en el sexo masculino, más del 80% presento comorbilidades. La mortalidad fue elevada y se asoció a viviendas en aéreas con&lt;100.000 habitantes y a la TB meníngea.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The World Health Organization estimates that 10 million new cases of Tuberculosis (TB) occur annually in the world, of which 10% occur in children &lt;15 years of age. Difficulties in accessing health facilities and delaying in the diagnosis and treatment increase mortality in childhood.  Objectives:  to evaluate the clinical and laboratory characteristics and factors associated with mortality in patients &lt; 19 years of age who were hospitalized for TB at the Institute of Tropical Medicine.  Materials and Methods:  this was a descriptive, retrospective, observational study. We included hospitalized patients diagnosed with TB during the years 2010 to 2018. The data were obtained from the Hospital Epidemiology Department's database. The variables were demographic data, clinical presentation, diagnosis, treatment and factors associated with mortality. Descriptive and analytical analysis was performed. Alpha error was considered &lt;5%. 98.  Results:  patients (pts) &#8804;19 years old were identified, with a mean age of 9.3 ± 6.3 years, 65.3% were male. 34.6% had human immunodeficiency virus infection, and 23.4% (23/98) had malnutrition; 42.4% lived in areas with a population with &lt;100,000 inhabitants and 23.4% belonged to native people groups. 19.4% (19/98) died. Mortality was associated with living in areas with a population with &lt;100,000 inhabitants (33.3% vs. 8.9%, p = 0.02. RR = 2.3. CI 1.1 - 5.0). Mortality was higher in meningeal tuberculosis presentations (46.2% vs. 15.3%, p &lt;0.01. RR = 3.0; CI 1.4 - 6.5).  Conclusions:  Tuberculosis predominated in males, more than 80% presented with comorbidities. Mortality was high and was associated with living in areas with &lt;100,000 inhabitants and TB meningeal form.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Tuberculosis]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[VIH]]></kwd>
<kwd lng="en"><![CDATA[Tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[HIV]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[World Health Organization Report 2018]]></source>
<year>2018</year>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wells]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global epidemiology of childhood tuberculosis]]></article-title>
<source><![CDATA[Int J Tuberc Lung Dis]]></source>
<year>2004</year>
<volume>8</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>636-47</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alvarez-Castillo]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Cano Escudero]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Taveira Jimenez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Microepidemias de tuberculosis en centros escolares ¿Cómo seleccionar los contactos?]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2007</year>
<volume>21</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>465-70</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Orcau]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Alnet]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Martinez-Roig]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transmission of childhood tuberculosis risk factors associated with an unidentified index case and outbreak evolution in Barcelona (1987-2007)]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Cayla]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<source><![CDATA[Pediatr Infect Dis J]]></source>
<year>2010</year>
<volume>29</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>876-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haas]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High time to tackle childhood tuberculosis]]></article-title>
<source><![CDATA[Euro Surveill]]></source>
<year>2011</year>
<volume>16</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>pii=19827</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Donald]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Maher]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Qazi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Stop TB Department and the Department of Child and Adolescent Health and Development of the World Health Organization. A research agenda for childhood tuberculosis. Improving the management of childhood tuberculosis within national tuberculosis programmes: research priorities based on a literature review]]></source>
<year>2007</year>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chintu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Mudenda]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Lucas]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Nunn]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lishimpi]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Maswahu]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lung diseases at necropsy in African children dying from respiratory illnesses: a descriptive necropsy study]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2002</year>
<numero>360</numero>
<issue>360</issue>
<page-range>985-90</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marais]]></surname>
<given-names><![CDATA[BJ]]></given-names>
</name>
<name>
<surname><![CDATA[Schaaf]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Childhood tuberculosis an emerging and previously neglected problem]]></article-title>
<source><![CDATA[Infect Dis Clin North Am]]></source>
<year>2010</year>
<volume>24</volume>
<page-range>727-49</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bermejo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Clavera]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Michel de la Rosa]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Marín]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiología de la tuberculosis]]></article-title>
<source><![CDATA[An Sist Sanit Navar.]]></source>
<year>2007</year>
<volume>30</volume>
<numero>^sSupl. 2</numero>
<issue>^sSupl. 2</issue>
<supplement>Supl. 2</supplement>
<page-range>7-19</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Low]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ang]]></surname>
<given-names><![CDATA[LW]]></given-names>
</name>
<name>
<surname><![CDATA[Cutter]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[James]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chee]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[YT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mortality among tuberculosis patients on treatment in Singapore]]></article-title>
<source><![CDATA[Int J Tuberc Lung Dis]]></source>
<year>2009</year>
<volume>13</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>328-34</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramos]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez-Butragueño]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tesfamariam]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Tiziano]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Endirays]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparing tuberculosis in children aged under 5 versus 5 to 14?years old in a rural hospital in southern Ethiopia: an 18-year retrospective cross-sectional study]]></article-title>
<source><![CDATA[BMC Public Health.]]></source>
<year>2019</year>
<volume>19</volume>
<page-range>856</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vázquez Rosales]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Acosta Gallegos]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Miranda Novales]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Fuentes Pacheco]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Labra Zamora]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Pacheco Rosas]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Análisis de una serie de casos de tuberculosis en pacientes pediátricos atendidos en un hospital de tercer nivel]]></article-title>
<source><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></source>
<year>2017</year>
<volume>74</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>27-33</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Starke]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis (Mycobacterium tuberculosis).]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Kliegman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Stanton]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Schor]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Behrman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Geme]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Tratado de Pediatría]]></source>
<year>2011</year>
<edition>19 ed</edition>
<publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[WB Saunders Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bisero]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Luque]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Borda]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Melillo]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Zapata]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Varela]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis en una población pediátrica atendida en un hospital público. Adherencia al tratamiento. Estudio descriptivo]]></article-title>
<source><![CDATA[Rev. Amer. Med. Respiratoria.]]></source>
<year>2013</year>
<volume>13</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gava]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Malacarne]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Giraldo Rios]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Sant'Anna]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Bastos Camacho]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Basta]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculose em crianças indígenas da Amazônia brasileira]]></article-title>
<source><![CDATA[Rev. Saúde Pública]]></source>
<year>2013</year>
<volume>47</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez-Valín]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Villarrubia Enseñat]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz García]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Sánchez]]></surname>
<given-names><![CDATA[EV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores de riesgo asociados a los resultados potencialmente insatisfactorios y a la mortalidad durante el tratamiento antituberculoso en España]]></article-title>
<source><![CDATA[Rev. Esp. Salud Publica]]></source>
<year>2015</year>
<volume>89</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
