D R Joel1, A P Steenhoff2, P C Mullan3, B R Phelps4, M A Tolle5, A Ho-Foster6, V Mabikwa7, B G Kgathi7, R Ncube8, G M Anabwani9. 1. Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana; Department of Paediatrics, Faculty of Health Sciences, University of Botswana School of Medicine, Gaborone, Botswana. 2. Department of Paediatrics, Faculty of Health Sciences, University of Botswana School of Medicine, Gaborone, Botswana; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 3. Children's National Medical Center, Washington, DC, USA. 4. Office of HIV/AIDS, US Agency for International Development, Washington, DC, USA. 5. Baylor College of Medicine, Houston, Texas, USA; Baylor Children's Foundation-Tanzania, Mwanza, Tanzania. 6. Botswana-UPenn Partnership, Gaborone, Botswana; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 7. Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana. 8. Ministry of Health, Botswana National TB Programme, Gaborone, Botswana. 9. Botswana-Baylor Children's Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana; Baylor College of Medicine, Houston, Texas, USA.
Abstract
SETTING: Four public hospitals in Botswana, a high tuberculosis (TB) burden setting. OBJECTIVES: To assess the feasibility and utility of sputum induction in the diagnosis of paediatric TB. DESIGN: From 2008 to 2010, children aged ≤18 years referred for suspected pulmonary TB underwent sputum induction. Confirmed TB was defined as the presence of at least one of the signs and symptoms suggestive of TB and positive Mycobacterium tuberculosis culture. Information on TB-associated symptoms (cough, fatigue, night sweats, low appetite, chest pain, weight loss, haemoptysis and contact with a TB case) was collected for three risk groups: human immunodeficiency virus (HIV) positive children, HIV-negative children aged <3 years and HIV-negative children aged ≥3 years. RESULTS: The median age of the 1394 subjects who underwent sputum induction was 3.8 years (IQR 1.3-8.4); 373 (27%) were HIV-positive, 419 (30%) were HIV-negative and 602 (43%) had unknown HIV status. TB was confirmed in 84 (6.0%); cases were more likely to have weight loss, chest pain or TB household contacts. There were no serious complications attributable to sputum induction during and after the procedure; only 0.8% (9/1174) of patients reported minor complications. CONCLUSIONS: In Botswana, paediatric sputum induction was feasible, safe and assisted bacteriological confirmation in a subgroup of children treated for TB.
SETTING: Four public hospitals in Botswana, a high tuberculosis (TB) burden setting. OBJECTIVES: To assess the feasibility and utility of sputum induction in the diagnosis of paediatric TB. DESIGN: From 2008 to 2010, children aged ≤18 years referred for suspected pulmonary TB underwent sputum induction. Confirmed TB was defined as the presence of at least one of the signs and symptoms suggestive of TB and positive Mycobacterium tuberculosis culture. Information on TB-associated symptoms (cough, fatigue, night sweats, low appetite, chest pain, weight loss, haemoptysis and contact with a TB case) was collected for three risk groups: human immunodeficiency virus (HIV) positive children, HIV-negative children aged <3 years and HIV-negative children aged ≥3 years. RESULTS: The median age of the 1394 subjects who underwent sputum induction was 3.8 years (IQR 1.3-8.4); 373 (27%) were HIV-positive, 419 (30%) were HIV-negative and 602 (43%) had unknown HIV status. TB was confirmed in 84 (6.0%); cases were more likely to have weight loss, chest pain or TB household contacts. There were no serious complications attributable to sputum induction during and after the procedure; only 0.8% (9/1174) of patients reported minor complications. CONCLUSIONS: In Botswana, paediatric sputum induction was feasible, safe and assisted bacteriological confirmation in a subgroup of children treated for TB.
Authors: Philipp du Cros; Bern-Thomas Nyang'wa; Marianne Gale; Sarah Venis; Nathan Ford Journal: Bull World Health Organ Date: 2011-12-01 Impact factor: 9.408
Authors: M Hatherill; T Hawkridge; H J Zar; A Whitelaw; M Tameris; L Workman; L Geiter; W A Hanekom; G Hussey Journal: Arch Dis Child Date: 2008-10-01 Impact factor: 3.791
Authors: Andrea N DeLuca; Laura L Hammitt; Julia Kim; Melissa M Higdon; Henry C Baggett; W Abdullah Brooks; Stephen R C Howie; Maria Deloria Knoll; Karen L Kotloff; Orin S Levine; Shabir A Madhi; David R Murdoch; J Anthony G Scott; Donald M Thea; Tussanee Amornintapichet; Juliet O Awori; Somchai Chuananon; Amanda J Driscoll; Bernard E Ebruke; Lokman Hossain; Yasmin Jahan; E Wangeci Kagucia; Sidi Kazungu; David P Moore; Azwifarwi Mudau; Lawrence Mwananyanda; Daniel E Park; Christine Prosperi; Phil Seidenberg; Mamadou Sylla; Milagritos D Tapia; Syed M A Zaman; Katherine L O'Brien Journal: Clin Infect Dis Date: 2017-06-15 Impact factor: 9.079