Browsing by Author "Du Preez, K."
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- ItemBacille Calmette-Guerin (BCG) vaccine and the COVID-19 pandemic : responsible stewardship is needed(The Union, 2020) Schaaf, H. S.; Du Preez, K.; Kruger, M.; Solomons, R.; Taljaard, J. J.; Rabie, H.; Seddon, J. A.; Cotton, M. F.; Tebruegge, M.; Curtis, N.; Hesseling, A. C.We believe that responsible stewardship of the bacille Calmette-Guérin (BCG) vaccine in the context of the COVID-19 epidemic is urgently needed. Live attenuated BCG is currently the only licensed vaccine to protect against tuberculosis (TB). Neonatal BCG vaccination has proven efficacy in protecting infants and young children against life-threatening disseminated forms of TB, including TB meningitis and miliary TB.
- ItemBurden, spectrum and outcomes of children with tuberculosis diagnosed at a district-level hospital in South Africa(International Union Against Tuberculosis and Lung Disease, 2018) Du Preez, K.; Du Plessis, L.; O’Connell, N.; Hesseling, A. C.SETTING: The Khayelitsha subdistrict has the highest burden of reported tuberculosis (TB) cases in Cape Town, Western Cape Province, South Africa. OBJECTIVES: To characterise the TB burden, spectrum and treatment outcomes among children managed at a district-level hospital, the Khayelitsha District Hospital. DESIGN: Retrospective medical record review of all children (age <13 years) diagnosed with TB in January–July 2014. A lay health care worker completed daily surveillance and supported linkage to TB care. Symptoms and investigations at presentation, TB disease spectrum, referral pathways and outcomes were reported. RESULTS: Most children were aged ≤2 years (84/99, 85%), 18/96 (19%) were infected with the human immunodeficiency virus, 31/91 (34%) were malnourished and 80/99 (81%) had pulmonary TB only. The majority of the children (63/80, 79%) presented with cough of acute onset (<2 weeks). Only 5/36 (14%) eligible child contacts had documentation of receiving isoniazid preventive therapy. Twelve (13%) children had bacteriologically confirmed pulmonary TB. Overall, 93/97 (96%) children successfully continued TB care after hospital discharge. Favourable TB treatment outcomes were recorded in only 77 (78%) children. CONCLUSIONS: Children with TB managed at this district-level hospital were young, and frequently had acute symptoms and substantial comorbidities. Missed opportunities for TB prevention were identified. Linkage to care support resulted in excellent continuation of TB care; however, treatment outcomes could be further improved.
- ItemClosing the reporting gap for childhood tuberculosis in South Africa : improving hospital referrals and linkages(IUATLD -- International Union Against Tuberculosis and Lung Disease, 2020-03-21) Du Preez, K.; Schaaf, H. S.; Dunbar, R.; Swartz, A.; Naidoo, P.; Hesseling, A. C.Setting: A referral hospital in Cape Town, Western Cape Province, Republic of South Africa. Objective: To measure the impact of a hospital-based referral service (intervention) to reduce initial loss to follow-up among children with tuberculosis (TB) and ensure the completeness of routine TB surveillance data. Design: A dedicated TB referral service was established in the paediatric wards at Tygerberg Hospital, Cape Town, in 2012. Allocated personnel provided TB education and counselling, TB referral support and weekly telephonic follow-up after hospital discharge. All children identified with TB were matched to electronic TB treatment registers (ETR.Net/EDRWeb). Multivariable logistic regression was used to compare reporting of culture-confirmed and drug-susceptible TB cases before (2007–2009) and during (2012) the intervention. Results: Successful referral with linkage to care was confirmed in 267/272 (98%) and successful reporting in 227/272 (84%) children. Children with drug-susceptible, culture-confirmed TB were significantly more likely to be reported during the intervention period than in the pre-intervention period (OR 2.52, 95%CI 1.33–4.77). The intervention effect remained consistent in multivariable analysis (adjusted OR 2.62; 95%CI 1.31–5.25) after adjusting for age, sex, human immunodeficiency virus status and the presence of TB meningitis. Conclusions: A simple hospital-based TB referral service can reduce initial loss to follow-up and improve recording and reporting of childhood TB in settings with decentralised TB services.
- ItemGlobal shortages of BCG vaccine and tuberculous meningitis in children(Elsevier, 2019) Du Preez, K.; Seddon, J. A.; Schaaf, H. S.; Hesseling, A. C.; Starke, J. R.; Osman, M.; Lombard, C. J.; Solomons, R.ENGLISH ABSTRACT: No abstract available.
- ItemWhere are we in the battle of ending tuberculosis in children and adolescents in South Africa?(Health & Medical Publishing Group, 2020) Du Preez, K.; Seddon, J. A.; Schaaf, H. Simon; Hesseling, A. C.Ambitious targets to end tuberculosis (TB) were set at the United Nations General Assembly High-Level Meeting (UNHLM) on TB in September 2018, with children and adolescents specifically noted as key populations deserving of more attention. [1] In addition, the World Health Organization (WHO) launched a revised ‘Roadmap towards ending TB in children and adolescents’,[2] outlining key actions that should be taken at country level to engage relevant stakeholders to optimally prevent and treat TB in these age groups