Julie Copelyn1,2, Brian Eley1,2, Helen Cox3, Lesley Workman2,4, Keertan Dheda5,6, Mark P Nicol7,8, Heather J Zar2,4. 1. Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. 2. Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 3. Division of Medical Microbiology, Wellcome Centre for Infectious Disease Research and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. 4. South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa. 5. Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa. 6. Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. 7. Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa. 8. Department of Biomedical Sciences, Division of Infection and Immunity, University of Western Australia, Perth, Australia.
Abstract
BACKGROUND: Data are limited on the resolution of symptoms and signs in children treated for pulmonary tuberculosis (PTB) and whether this resolution differs from children with other lower respiratory tract infections (LRTIs). METHODS: A prospective study of children ≤ 15 years presenting with features suggestive of PTB was performed. Clinical, microbiological, and radiological investigations were done at enrollment. Symptoms and clinical features were measured 1, 3, and 6 months after enrollment. Participants were categorized into 3 groups based on National Institutes of Health consensus definitions: confirmed PTB, unconfirmed PTB, and unlikely PTB (children with other LRTIs). Univariable and multivariable logistic regression modeling was used to investigate predictors of persistence of symptoms or signs. RESULTS: Among 2019 participants, there were 427 (21%) confirmed, 810 (40%) unconfirmed, and 782 (39%) with unlikely PTB. Of 1693/2008 (84%) with cough and 1157/1997 (58%) with loss of appetite at baseline, persistence at 3 months was reported in 24/1222 (2%) and 23/886 (3%), respectively. Of 934/1884 (50%) with tachypnoea and 947/1999 (47%) with abnormal auscultatory findings at baseline, persistence at 3 months occurred in 410/723 (57%) and 216/778 (28%), respectively. HIV infection and abnormal baseline chest radiography were associated with persistence of symptoms or signs at month 3 (adjusted odds ration [aOR] 1.6; 95% confidence interval [CI]: [1.1, 2.3] and aOR 2.3; 95% CI: [1.5, 3.3], respectively]. The resolution of symptoms and signs was similar across categories. CONCLUSIONS: Symptoms resolved rapidly in most children with PTB, but signs resolved more slowly. The pattern and resolution of symptoms or signs did not distinguish children with PTB from those with other LRTIs.
BACKGROUND: Data are limited on the resolution of symptoms and signs in children treated for pulmonary tuberculosis (PTB) and whether this resolution differs from children with other lower respiratory tract infections (LRTIs). METHODS: A prospective study of children ≤ 15 years presenting with features suggestive of PTB was performed. Clinical, microbiological, and radiological investigations were done at enrollment. Symptoms and clinical features were measured 1, 3, and 6 months after enrollment. Participants were categorized into 3 groups based on National Institutes of Health consensus definitions: confirmed PTB, unconfirmed PTB, and unlikely PTB (children with other LRTIs). Univariable and multivariable logistic regression modeling was used to investigate predictors of persistence of symptoms or signs. RESULTS: Among 2019 participants, there were 427 (21%) confirmed, 810 (40%) unconfirmed, and 782 (39%) with unlikely PTB. Of 1693/2008 (84%) with cough and 1157/1997 (58%) with loss of appetite at baseline, persistence at 3 months was reported in 24/1222 (2%) and 23/886 (3%), respectively. Of 934/1884 (50%) with tachypnoea and 947/1999 (47%) with abnormal auscultatory findings at baseline, persistence at 3 months occurred in 410/723 (57%) and 216/778 (28%), respectively. HIV infection and abnormal baseline chest radiography were associated with persistence of symptoms or signs at month 3 (adjusted odds ration [aOR] 1.6; 95% confidence interval [CI]: [1.1, 2.3] and aOR 2.3; 95% CI: [1.5, 3.3], respectively]. The resolution of symptoms and signs was similar across categories. CONCLUSIONS: Symptoms resolved rapidly in most children with PTB, but signs resolved more slowly. The pattern and resolution of symptoms or signs did not distinguish children with PTB from those with other LRTIs.
Authors: S Moyo; S Verver; A Hawkridge; L Geiter; M Hatherill; L Workman; C Ontong; W Msemburi; M Tameris; H Geldenhuys; H Mulenga; M A Snowden; W A Hanekom; G Hussey; H Mahomed Journal: Int J Tuberc Lung Dis Date: 2012-02 Impact factor: 2.373
Authors: Heather J Zar; Lesley J Workman; Margaretha Prins; Linda J Bateman; Slindile P Mbhele; Cynthia B Whitman; Claudia M Denkinger; Mark P Nicol Journal: Am J Respir Crit Care Med Date: 2019-12-15 Impact factor: 21.405
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: Rhiannon Heslop; Adama L Bojang; Sheikh Jarju; Joseph Mendy; Sarah Mulwa; Ousman Secka; Francis S Mendy; Olumuyiwa Owolabi; Beate Kampmann; Jayne S Sutherland Journal: PLoS One Date: 2016-12-16 Impact factor: 3.240