OBJECTIVES: To describe the clinical presentation, delay in diagnosis and treatment initiation, and outcome of culture-confirmed childhood tuberculosis. METHODS: Retrospective study of children<13 years of age at Tygerberg Children's Hospital, Cape Town, South Africa with culture-confirmed tuberculosis seen January 2002-June 2003. Data were collected by review of hospital and clinic records. RESULTS: Culture-confirmed tuberculosis was diagnosed in 184 children, median age 36 months; 26 (14.1%) were diagnosed clinically and treatment was started before admission. Tuberculosis was newly diagnosed in 158 children; 127 (80.4%) were clinically diagnosed and 31 (19.6%) were diagnosed only after culture result was known (culture-diagnosed). The median time from admission to diagnosis was 1 day (1-21 days) for clinically diagnosed, and 73 (34-178 days) for culture-diagnosed children. Treatment was initiated by hospital physicians in all 127 clinically diagnosed and 14/31 culture-diagnosed children. Of the 17 culture-diagnosed children not started on treatment, 4 were subsequently diagnosed on clinical grounds and treated at clinic level, 8 were found in good health, 4 failed to follow-up and 1 neonate died before the culture result was known. CONCLUSIONS: In symptomatic children, the vast majority could be confidently diagnosed on clinical grounds. However, culture-confirmation remains valuable to establish drug susceptibility.
OBJECTIVES: To describe the clinical presentation, delay in diagnosis and treatment initiation, and outcome of culture-confirmed childhood tuberculosis. METHODS: Retrospective study of children<13 years of age at Tygerberg Children's Hospital, Cape Town, South Africa with culture-confirmed tuberculosis seen January 2002-June 2003. Data were collected by review of hospital and clinic records. RESULTS: Culture-confirmed tuberculosis was diagnosed in 184 children, median age 36 months; 26 (14.1%) were diagnosed clinically and treatment was started before admission. Tuberculosis was newly diagnosed in 158 children; 127 (80.4%) were clinically diagnosed and 31 (19.6%) were diagnosed only after culture result was known (culture-diagnosed). The median time from admission to diagnosis was 1 day (1-21 days) for clinically diagnosed, and 73 (34-178 days) for culture-diagnosed children. Treatment was initiated by hospital physicians in all 127 clinically diagnosed and 14/31 culture-diagnosed children. Of the 17 culture-diagnosed children not started on treatment, 4 were subsequently diagnosed on clinical grounds and treated at clinic level, 8 were found in good health, 4 failed to follow-up and 1 neonate died before the culture result was known. CONCLUSIONS: In symptomatic children, the vast majority could be confidently diagnosed on clinical grounds. However, culture-confirmation remains valuable to establish drug susceptibility.
Authors: Peter C Drobac; Sonya S Shin; Pedro Huamani; Sidney Atwood; Jennifer Furin; Molly F Franke; Charmaine Lastimoso; Hernan del Castillo Journal: Pediatrics Date: 2012-07-23 Impact factor: 7.124
Authors: Stephen M Graham; Luis E Cuevas; Patrick Jean-Philippe; Renee Browning; Martina Casenghi; Anne K Detjen; Devasena Gnanashanmugam; Anneke C Hesseling; Beate Kampmann; Anna Mandalakas; Ben J Marais; Marco Schito; Hans M L Spiegel; Jeffrey R Starke; Carol Worrell; Heather J Zar Journal: Clin Infect Dis Date: 2015-10-15 Impact factor: 9.079
Authors: H Simon Schaaf; Ben J Marais; Andrew Whitelaw; Anneke C Hesseling; Brian Eley; Gregory D Hussey; Peter R Donald Journal: BMC Infect Dis Date: 2007-11-29 Impact factor: 3.090