Sputum induction for microbiological diagnosis of childhood pulmonary tuberculosis in a community setting
OBJECTIVE: To investigate the yield, feasibility and safety of sputum induction for the diagnosis of TB in children in a primary health care facility.
DESIGN: A prospective study in a primary health care clinic in South Africa from April 2007 to June 2009. Consecutive children with clinically suspected PTB, with a household adult PTB contact or human immunodeficiency virus infected with respiratory symptoms were enrolled. History, clinical examination, tuberculin skin test and chest X-ray results were recorded. Two sequential induced sputum specimens were obtained for smear and culture.
RESULTS: A total of 270 children were enrolled (median age 38 months); sputum induction was successful in 269 (99%); 65 (24%) children were clinically diagnosed, of whom 11 (16.9%) were microbiologically confirmed. An additional 18 children not clinically diagnosed had microbiological confirmation of PTB and were placed on TB treatment thereafter, increasing the diagnostic yield by 21.6%, from 65 to 83 cases. Sputum induction procedures were well tolerated; no major adverse events occurred.
CONCLUSION: Sputum induction is feasible and safe in a community setting. Sputum induction was useful for making a microbiological diagnosis, increasing the number of children diagnosed and treated for PTB.
Keywords: HIV; children; primary care; sputum induction; tuberculosis
Document Type: Regular Paper
Affiliations: 1: Kuyasa Clinic, Khayelitsha, Cape Town, South Africa; Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa 2: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa 3: Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
Publication date: 01 September 2011
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