Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases

 

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dc.contributor.author Schaaf, H Simon en_ZA
dc.contributor.author Marais, Ben en_ZA
dc.contributor.author Whitelaw, Andrew en_ZA
dc.contributor.author Hesseling, Anneke en_ZA
dc.contributor.author Eley, Brian en_ZA
dc.contributor.author Hussey, Gregory en_ZA
dc.contributor.author Donald, Peter en_ZA
dc.date.accessioned 2015-10-12T10:58:55Z
dc.date.available 2015-10-12T10:58:55Z
dc.date.issued 2007 en_ZA
dc.identifier.citation Schaaf, H. S., Marais, B., Whitelaw, A., Hesseling, A., Eley, B., Hussey, G., & Donald, P. (2007). Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. BMC infectious diseases, 7(1), 140. en_ZA
dc.identifier.uri 10.1186/1471-2334-7-140 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14199
dc.description.abstract BACKGROUND:The clinical, radiological and microbiological features of culture-confirmed childhood tuberculosis diagnosed at two referral hospitals are described. METHODS: Cultures of Mycobacterium tuberculosis from children less than 13 years of age at Tygerberg and Red Cross Children's Hospitals, Cape Town, South Africa, were collected from March 2003 through February 2005. Folder review and chest radiography were performed and drug susceptibility tests done. RESULTS: Of 596 children (median age 31 months), 330 (55.4%) were males. Of all children, 281 (47.1%) were HIV-uninfected, 133 (22.3%) HIV-infected and 182 (30.5%) not tested. Contact with infectious tuberculosis adults was recorded in 295 (49.5%) children. Missed opportunities for chemoprophylaxis were present in 117/182 (64.3%) children less than 5 years of age.Extrathoracic TB was less common in HIV-infected than in HIV-uninfected children (49/133 vs. 156/281; odds ratio 0.50, 95% confidence interval 0.32-0.78). Alveolar opacification (84/126 vs. 128/274; OR 1.85, 95%CI 1.08-3.19) and cavitation (33/126 vs. 44/274; OR 2.28, 95%CI 1.44-3.63) were more common in HIV-infected than in HIV-uninfected children. Microscopy for acid-fast bacilli on gastric aspirates and sputum was positive in 29/142 (20.4%) and 40/125 (32.0%) children, respectively. Sixty-seven of 592 (11.3%) children's isolates showed resistance to isoniazid and/or rifampicin; 43 (7.3%) were isoniazid-monoresistant, 2 (0.3%) rifampicin-monoresistant and 22 (3.7%) multidrug-resistant. Death in 41 children (6.9%) was more common in HIV-infected children and very young infants. CONCLUSION: HIV infection and missed opportunities for chemoprophylaxis were common in children with culture-confirmed TB. With cavitating disease and sputum or gastric aspirates positive for acid-fast bacilli, children may be infectious. Transmission of drug-resistant TB is high in this setting. en_ZA
dc.language.iso eng en_ZA
dc.publisher Biomed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source BMC Infectious Diseases en_ZA
dc.source.uri http://www.biomedcentral.com/bmcinfectdis/ en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other Diagnosis en_ZA
dc.subject.other Screening en_ZA
dc.title Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases en_ZA
dc.type Journal Article en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Clinical Laboratory Sciences en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Schaaf, H. S., Marais, B., Whitelaw, A., Hesseling, A., Eley, B., Hussey, G., & Donald, P. (2007). Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/14199 en_ZA
dc.identifier.chicagocitation Schaaf, H Simon, Ben Marais, Andrew Whitelaw, Anneke Hesseling, Brian Eley, Gregory Hussey, and Peter Donald "Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases." <i>BMC Infectious Diseases</i> (2007) http://hdl.handle.net/11427/14199 en_ZA
dc.identifier.vancouvercitation Schaaf HS, Marais B, Whitelaw A, Hesseling A, Eley B, Hussey G, et al. Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases. BMC Infectious Diseases. 2007; http://hdl.handle.net/11427/14199. en_ZA
dc.identifier.ris TY - Journal Article AU - Schaaf, H Simon AU - Marais, Ben AU - Whitelaw, Andrew AU - Hesseling, Anneke AU - Eley, Brian AU - Hussey, Gregory AU - Donald, Peter AB - BACKGROUND:The clinical, radiological and microbiological features of culture-confirmed childhood tuberculosis diagnosed at two referral hospitals are described. METHODS: Cultures of Mycobacterium tuberculosis from children less than 13 years of age at Tygerberg and Red Cross Children's Hospitals, Cape Town, South Africa, were collected from March 2003 through February 2005. Folder review and chest radiography were performed and drug susceptibility tests done. RESULTS: Of 596 children (median age 31 months), 330 (55.4%) were males. Of all children, 281 (47.1%) were HIV-uninfected, 133 (22.3%) HIV-infected and 182 (30.5%) not tested. Contact with infectious tuberculosis adults was recorded in 295 (49.5%) children. Missed opportunities for chemoprophylaxis were present in 117/182 (64.3%) children less than 5 years of age.Extrathoracic TB was less common in HIV-infected than in HIV-uninfected children (49/133 vs. 156/281; odds ratio 0.50, 95% confidence interval 0.32-0.78). Alveolar opacification (84/126 vs. 128/274; OR 1.85, 95%CI 1.08-3.19) and cavitation (33/126 vs. 44/274; OR 2.28, 95%CI 1.44-3.63) were more common in HIV-infected than in HIV-uninfected children. Microscopy for acid-fast bacilli on gastric aspirates and sputum was positive in 29/142 (20.4%) and 40/125 (32.0%) children, respectively. Sixty-seven of 592 (11.3%) children's isolates showed resistance to isoniazid and/or rifampicin; 43 (7.3%) were isoniazid-monoresistant, 2 (0.3%) rifampicin-monoresistant and 22 (3.7%) multidrug-resistant. Death in 41 children (6.9%) was more common in HIV-infected children and very young infants. CONCLUSION: HIV infection and missed opportunities for chemoprophylaxis were common in children with culture-confirmed TB. With cavitating disease and sputum or gastric aspirates positive for acid-fast bacilli, children may be infectious. Transmission of drug-resistant TB is high in this setting. DA - 2007 DB - OpenUCT DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2007 T1 - Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases TI - Culture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 cases UR - http://hdl.handle.net/11427/14199 ER - en_ZA


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