Radiographic signs and symptoms in children treated for tuberculosis: Possible implications for symptom-based screening in resource-limited settings
dc.contributor.author | Marais B.J. | |
dc.contributor.author | Gie R.P. | |
dc.contributor.author | Hesseling A.C. | |
dc.contributor.author | Schaaf H.S. | |
dc.contributor.author | Enarson D.A. | |
dc.contributor.author | Beyers N. | |
dc.date.accessioned | 2011-05-15T16:00:07Z | |
dc.date.available | 2011-05-15T16:00:07Z | |
dc.date.issued | 2006 | |
dc.description.abstract | Background: The World Health Organization advises active tracing of children younger than 5 years old in household contact with a sputum smear-positive tuberculosis index case. This study compared radiographic disease manifestations in 2 groups of children treated for tuberculosis in an endemic setting: those who presented with suspicious symptoms; and those actively traced as household contacts of an adult index case. Methods: We conducted a prospective descriptive study from February 2003 through October 2004 at 5 primary health care clinics in Cape Town South Africa, including all children (younger than 5 years old) treated for tuberculosis (TB). Results: A total of 326 children (younger than 5 years old) received antituberculosis treatment; 190 (58.3%) presented with suspicious symptoms, and 136 (41.7%) were actively traced contacts. Children were categorized as; "not TB" 71 (22%), intrathoracic tuberculosis 230 (70%) and extrathoracic tuberculosis 25 (8%). Significantly more actively traced contacts were categorized as "not TB" (odds ratio, 7.4; 95% confidence interval, 3.8-14.3), or demonstrated elements of the primary complex only on the chest radiograph (odds ratio, 26.2; 95% confidence interval, 8.6-89.2), compared with children who presented with suspicious symptoms. Of all children diagnosed with intrathoracic tuberculosis, 20 of 230 (9%) reported no symptoms, all of whom demonstrated elements of the primary complex only. Conclusions: The majority of actively traced contacts had minimal disease. Symptom-based screening would have identified all but 9% of children diagnosed with intrathoracic tuberculosis, all of whom demonstrated elements of the primary complex only. Further investigation is required to establish whether symptom-based screening can be justified to improve access to preventive chemotherapy in resource-limited endemic settings. Copyright © 2006 by Lippincott Williams & Wilkins. | |
dc.description.version | Article | |
dc.identifier.citation | Pediatric Infectious Disease Journal | |
dc.identifier.citation | 25 | |
dc.identifier.citation | 3 | |
dc.identifier.issn | 8913668 | |
dc.identifier.other | 10.1097/01.inf.0000202140.76368.74 | |
dc.identifier.uri | http://hdl.handle.net/10019.1/11534 | |
dc.subject | isoniazid | |
dc.subject | tuberculostatic agent | |
dc.subject | article | |
dc.subject | disease classification | |
dc.subject | endemic disease | |
dc.subject | extrathoracic tuberculosis | |
dc.subject | female | |
dc.subject | health care access | |
dc.subject | household | |
dc.subject | human | |
dc.subject | intrathoracic tuberculosis | |
dc.subject | major clinical study | |
dc.subject | male | |
dc.subject | nonhuman | |
dc.subject | preschool child | |
dc.subject | primary health care | |
dc.subject | priority journal | |
dc.subject | prospective study | |
dc.subject | screening test | |
dc.subject | South Africa | |
dc.subject | sputum smear | |
dc.subject | symptomatology | |
dc.subject | thorax radiography | |
dc.subject | tuberculosis | |
dc.subject | world health organization | |
dc.subject | Antitubercular Agents | |
dc.subject | Child, Preschool | |
dc.subject | Contact Tracing | |
dc.subject | Female | |
dc.subject | Health Resources | |
dc.subject | Humans | |
dc.subject | Male | |
dc.subject | Mass Screening | |
dc.subject | South Africa | |
dc.subject | Tuberculin Test | |
dc.subject | Tuberculosis | |
dc.subject | Tuberculosis, Pulmonary | |
dc.title | Radiographic signs and symptoms in children treated for tuberculosis: Possible implications for symptom-based screening in resource-limited settings | |
dc.type | Article |