A critical look at the diagnostic value of culture-confirmation in childhood tuberculosis

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dc.contributor.authorEngelbrecht A.L.
dc.contributor.authorMarais B.J.
dc.contributor.authorDonald P.R.
dc.contributor.authorSchaaf H.S.
dc.date.accessioned2011-05-15T16:17:00Z
dc.date.available2011-05-15T16:17:00Z
dc.date.issued2006
dc.description.abstractObjectives: To describe the clinical presentation, delay in diagnosis and treatment initiation, and outcome of culture-confirmed childhood tuberculosis. Methods: Retrospective study of children < 13 years of age at Tygerberg Children's Hospital, Cape Town, South Africa with culture-confirmed tuberculosis seen January 2002-June 2003. Data were collected by review of hospital and clinic records. Results: Culture-confirmed tuberculosis was diagnosed in 184 children, median age 36 months; 26 (14.1%) were diagnosed clinically and treatment was started before admission. Tuberculosis was newly diagnosed in 158 children; 127 (80.4%) were clinically diagnosed and 31 (19.6%) were diagnosed only after culture result was known (culture-diagnosed). The median time from admission to diagnosis was 1 day (1-21 days) for clinically diagnosed, and 73 (34-178 days) for culture-diagnosed children. Treatment was initiated by hospital physicians in all 127 clinically diagnosed and 14/31 culture-diagnosed children. Of the 17 culture-diagnosed children not started on treatment, 4 were subsequently diagnosed on clinical grounds and treated at clinic level, 8 were found in good health, 4 failed to follow-up and 1 neonate died before the culture result was known. Conclusions: In symptomatic children, the vast majority could be confidently diagnosed on clinical grounds. However, culture-confirmation remains valuable to establish drug susceptibility. © 2006 The British Infection Society.
dc.description.versionArticle
dc.identifier.citationJournal of Infection
dc.identifier.citation53
dc.identifier.citation6
dc.identifier.issn01634453
dc.identifier.other10.1016/j.jinf.2005.12.025
dc.identifier.urihttp://hdl.handle.net/10019.1/14026
dc.subjecttuberculostatic agent
dc.subjectarticle
dc.subjectbacterium culture
dc.subjectchild
dc.subjectchildhood disease
dc.subjectclinical feature
dc.subjectcontrolled study
dc.subjectdelayed diagnosis
dc.subjectdiagnostic procedure
dc.subjectdiagnostic value
dc.subjectdrug sensitivity
dc.subjectextrapulmonary tuberculosis
dc.subjectfemale
dc.subjectfollow up
dc.subjecthealth status
dc.subjecthospital admission
dc.subjecthospital physician
dc.subjecthuman
dc.subjectinformation processing
dc.subjectlung tuberculosis
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectMycobacterium tuberculosis
dc.subjectnewborn death
dc.subjectoutcomes research
dc.subjectretrospective study
dc.subjectSouth Africa
dc.subjecttuberculosis
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectEnzyme-Linked Immunosorbent Assay
dc.subjectFemale
dc.subjectHumans
dc.subjectInfant
dc.subjectInfant, Newborn
dc.subjectLaboratory Techniques and Procedures
dc.subjectMale
dc.subjectMedical Records
dc.subjectPolymerase Chain Reaction
dc.subjectRetrospective Studies
dc.subjectSouth Africa
dc.subjectTime Factors
dc.subjectTuberculosis, Pulmonary
dc.titleA critical look at the diagnostic value of culture-confirmation in childhood tuberculosis
dc.typeArticle
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