Assessment, diagnosis and management of pulmonary tuberculosis in children under five years of age in the Langeberg sub-district, Western Cape, South Africa
Date
2020-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Background: TB remains one of the top 10 leading causes of death worldwide as millions of people still contract the disease annually. It is estimated that TB caused between 1.2 and 1.4 million deaths globally in 2017. The incidence of TB in children is a reflection of the underlying factors that fuel the TB epidemic, as these infections reflect ongoing TB-transmission.
Aim: To describe how the diagnosis of Pulmonary Tuberculosis (PTB) in children under 5 years is
made in the Langeberg sub-district.
Setting: The Langeberg sub-district includes Robertson and Montagu District Hospitals as well as
their surrounding clinics. A total of nine primary healthcare (PHC) clinics as well as two mobile clinics
serving the farm areas in the sub-district were included.
Methods: A retrospective descriptive study was conducted. The researcher obtained statistics from
the information management department of the Langeberg sub-district and utilised information of
all known and notified cases of tuberculosis in the district. All cases of PTB diagnosed from 1st January 2018 to 31st December 2018, in children under 5 years of age were included.
Results: A total sample of 166 folders were reviewed. A proven positive adult contact was identified
in 39% of cases. A suggestive chest x-ray was found in 93,4% of cases although specific CXR findings
were not documented. Gastric washings were done in 52 of the children and had a positive yield of 13%. A total of 4,7% had HIV/TB co-infection and 12% had comorbid malnutrition. 85,5% of children had a positive treatment outcome (treatment completed or cured).
Conclusion: The diagnosis of PTB in children primarily remains a radiological diagnosis, but clinical factors like symptoms and their duration, weight trends and the presence of an adult contact have also been considered. Microbiological confirmation was absent in the majority of cases started on TB treatment. Comorbid HIV infection, malnutrition or asthma did not contribute to increased risk for adverse outcomes. Contact tracing needs to be improved within the sub-district.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MFamMed)--Stellenbosch University, 2022.
Keywords
Tuberculosis in children -- Diagnosis -- South Africa, Tuberculosis -- Diagnosis -- South Africa, Pulmonary Tuberculosis, UCTD