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

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dc.contributor.authorSchaaf, H Simonen_ZA
dc.contributor.authorMarais, Benen_ZA
dc.contributor.authorWhitelaw, Andrewen_ZA
dc.contributor.authorHesseling, Annekeen_ZA
dc.contributor.authorEley, Brianen_ZA
dc.contributor.authorHussey, Gregoryen_ZA
dc.contributor.authorDonald, Peteren_ZA
dc.date.accessioned2015-10-12T10:58:55Z
dc.date.available2015-10-12T10:58:55Z
dc.date.issued2007en_ZA
dc.description.abstractBACKGROUND: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.identifier.apacitationSchaaf, 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/11427/14199en_ZA
dc.identifier.chicagocitationSchaaf, 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/11427/14199en_ZA
dc.identifier.citationSchaaf, 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.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
dc.identifier.uri10.1186/1471-2334-7-140en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14199
dc.identifier.vancouvercitationSchaaf 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.language.isoengen_ZA
dc.publisherBiomed Central Ltden_ZA
dc.publisher.departmentDepartment of Clinical Laboratory Sciencesen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Infectious Diseasesen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcinfectdis/en_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherDiagnosisen_ZA
dc.subject.otherScreeningen_ZA
dc.titleCulture-confirmed childhood tuberculosis in Cape Town, South Africa: a review of 596 casesen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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