Frequency of Anemia in Children With Pulmonary Tuberculosis Presenting at a Tertiary Care Hospital

Anemia is a frequently reported hematological complication of tuberculosis (TB), and its presence may complicate clinical assessment and management in affected children. This study determined the frequency, morphological patterns, and severity of anemia among children with pulmonary tuberculosis treated at a tertiary care hospital in Lahore, Pakistan. A cross-sectional study was conducted in the Department of Pediatric Medicine, Gulab Devi Hospital, from March to July 2026. Using consecutive sampling, 100 children aged 6–12 years with pulmonary TB were enrolled. Demographic and clinical information was recorded, and complete blood counts, peripheral blood smears, iron-related investigations, and selected biochemical tests were performed. Anemia was classified according to the study’s prespecified hemoglobin cutoff of less than 11.2 g/dL; this study-specific cutoff differs from international age-specific recommendations. Of the 100 children, 68 (68.0%) were classified as anemic. Among anemic participants, moderate anemia was the most frequent severity category (36/68; 52.9%), followed by mild (23/68; 33.8%) and severe anemia (9/68; 13.2%). Microcytic hypochromic anemia predominated (47/68; 69.1%), followed by normocytic normochromic anemia (17/68; 25.0%) and macrocytic anemia (4/68; 5.9%). The reported etiological classifications were anemia of chronic disease (48%), iron-deficiency anemia (41%), and mixed or unclassified anemia (11%). Anemia was observed in 35/48 girls (72.9%) and 33/52 boys (63.5%); no statistical significance test for this sex difference was reported. Elevated C-reactive protein and hypoalbuminemia were reported to be associated with anemia (p < 0.05), although detailed estimates were unavailable. Anemia was frequent among children with pulmonary TB in this hospital-based sample. Routine hematological assessment and context-sensitive interpretation of iron studies may support timely recognition of anemia, while larger studies using standardized pediatric diagnostic thresholds are needed to confirm the findings.