Paediatric admissions to a tuberculosis hospital: reasons for admission, clinical profile and outcome
Date
2021-12
Authors
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Abstract
ENGLISH ABSTRACT: Background: Brooklyn Chest Hospital (BCH) is a specialized tuberculosis hospital in
Cape Town, South Africa. We describe patient profiles and hospital discharge
outcomes of paediatric tuberculosis patients admitted to BCH.
Methods: This retrospective, descriptive study included all children (0-15 years)
admitted to BCH from January 2016 through December 2017. Data collected from
patient folders and a laboratory database included demographic data, reasons for
admission, clinical data and hospital discharge outcome.
Results: Of 263 children admitted, 133 (50.6%) were male. The median age was 32
months (IQR 15-75 months); 48 (18.3%) were HIV-positive and 150 (57.0%) had
bacteriologically-confirmed tuberculosis. Reasons for admission included
social/caregiver-related challenges (119; 45.2%), drug-resistant tuberculosis (114;
43.3%), TB meningitis (86; 32.7%) and other severe TB types (63; 24.0%); 110
(41.8%) children had >1 reason for admission. Median in-hospital stay at BCH was
130 days (IQR 79-182). Pulmonary tuberculosis was diagnosed in 234 (89.0%),
extrapulmonary tuberculosis in 149 (56.7%) and 126 children (47.9%) had both. At
discharge, 73 (27.8%) had completed treatment, 182 (69.2%) were transferred out to
complete treatment at community clinics, 6 (2.3%) died, 1 absconded and 1 had a
changed diagnosis.
Conclusions: Most children were admitted for clinical reasons, although
social/caregiver-related reasons were important in the decision to admit.
AFRIKAANS OPSOMMING: Agtergrond: Brooklyn Chest Hospitaal (BCH) is ‘n gespesialiseerde tuberkulose hospitaal in Kaapstad, Suid-Afrika. Pasiëntprofiele en hospitaal-ontslag uitkomste van pediatriese tuberkulose pasiënte wat toegelaat was in BCH word hier bespreek. Metodes: Hierdie retrospektiewe, beskrywende studie het alle kinders (0-15 jaar) wat toegelaat is in BCH vanaf Januarie 2016 tot Desember 2017 ingesluit. Data wat van pasiëntlêers en ‘n laboratorium databasis versamel is, het demografiese data, redes vir toelating, kliniese data en hospitaal-ontslag uitkoms ingesluit. Resultate: Van die 263 kinders wat toegelaat is, was 133 (50.6%) manlike. Die mediane ouderdom was 32 maande (IKR 15-75 maande); 48 (18.3%) was MIV-positief en 150 (57.0%) het bakteriologies-bevestigde tuberkulose gehad. Redes vir toelating was sosiaal/versorger-verwant (119; 45.2%), middelweerstandige tuberkulose (114; 43.3%), TB meningitis (86; 32.7%) en ander erge tipes tuberkulose (63; 24.0%); 110 (41.8%) van die kinders het >1 rede vir toelating gehad. Die mediane hospitaaltoelatingstyd in BCH was 130 dae (IKR 79-182). Pulmonale (long) tuberkulose was in 234 (89.0%) gediagnoseer, ekstrapulmonale tuberkulose in 149 (56.7%) en beide in 126 (47.9%). Met ontslag was 73 (27.8%) se behandeling voltooi, 182 (69.2%) is na gemeenskapsklinieke oorgeplaas om behandeling te voltooi, 6 (2.3%) het gesterf, 1 het weggeloop en 1 se diagnose het verander. Gevolgtrekkings: Die meeste kinders is vir kliniese redes toegelaat, maar sosiale/versorger-verwante redes was belangrik in die besluit om kinders toe te laat.
AFRIKAANS OPSOMMING: Agtergrond: Brooklyn Chest Hospitaal (BCH) is ‘n gespesialiseerde tuberkulose hospitaal in Kaapstad, Suid-Afrika. Pasiëntprofiele en hospitaal-ontslag uitkomste van pediatriese tuberkulose pasiënte wat toegelaat was in BCH word hier bespreek. Metodes: Hierdie retrospektiewe, beskrywende studie het alle kinders (0-15 jaar) wat toegelaat is in BCH vanaf Januarie 2016 tot Desember 2017 ingesluit. Data wat van pasiëntlêers en ‘n laboratorium databasis versamel is, het demografiese data, redes vir toelating, kliniese data en hospitaal-ontslag uitkoms ingesluit. Resultate: Van die 263 kinders wat toegelaat is, was 133 (50.6%) manlike. Die mediane ouderdom was 32 maande (IKR 15-75 maande); 48 (18.3%) was MIV-positief en 150 (57.0%) het bakteriologies-bevestigde tuberkulose gehad. Redes vir toelating was sosiaal/versorger-verwant (119; 45.2%), middelweerstandige tuberkulose (114; 43.3%), TB meningitis (86; 32.7%) en ander erge tipes tuberkulose (63; 24.0%); 110 (41.8%) van die kinders het >1 rede vir toelating gehad. Die mediane hospitaaltoelatingstyd in BCH was 130 dae (IKR 79-182). Pulmonale (long) tuberkulose was in 234 (89.0%) gediagnoseer, ekstrapulmonale tuberkulose in 149 (56.7%) en beide in 126 (47.9%). Met ontslag was 73 (27.8%) se behandeling voltooi, 182 (69.2%) is na gemeenskapsklinieke oorgeplaas om behandeling te voltooi, 6 (2.3%) het gesterf, 1 het weggeloop en 1 se diagnose het verander. Gevolgtrekkings: Die meeste kinders is vir kliniese redes toegelaat, maar sosiale/versorger-verwante redes was belangrik in die besluit om kinders toe te laat.
Description
Thesis (MMed)--Stellenbosch University, 2021
Keywords
Tuberculosis in children, Communicable diseases in infants, Pediatrics, UCTD