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Free Content The spectrum of disease in children treated for tuberculosis in a highly endemic area [Unresolved Issues]

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BACKGROUND: Children contribute a substantial proportion of the global tuberculosis (TB) caseload, particularly in endemic areas, where little is known about their spectrum of disease.

OBJECTIVE: To document the complete disease spectrum, with relevant age- and HIV-related differences, in children treated for TB in a highly endemic community.

METHODS: A prospective descriptive study was conducted from February 2003 to October 2004 at five primary health care clinics in Cape Town, South Africa, including all children (<13 years of age) treated for TB.

RESULTS: In total, 439 children received anti-tuberculosis treatment. The spectrum of disease included 85 (19.4%) ‘not TB’, 307 (86.7%) intra-thoracic TB and 72 (20.3%) extra-thoracic TB (25 [5.7%] with co-existing intra- and extra-thoracic disease were included in both groups). In non-HIV-infected children, disseminated (miliary) disease (9/11, 81.8%) and tuberculous meningitis (TBM) (10/13, 76.9%) were predominantly documented in children <3 years of age. In HIV-infected children, complicated Ghon focus and disseminated (miliary) disease were significantly more common (6/25, 24.0%) than in non-HIV-infected children (12/414, 2.9%) (OR 10.9, 95%CI 3.2–35.9).

CONCLUSION: This study describes the complete disease spectrum observed in children treated for TB in a highly endemic area. Children suffered significant morbidity, with most severe disease recorded in very young and/or HIV-infected children.
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Keywords: childhood tuberculosis; disease spectrum; endemic

Document Type: Miscellaneous

Affiliations: 1: Desmond Tutu TB Centre and Department of Paediatrics and Child Health, Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa 2: International Union Against Tuberculosis and Lung Disease, Paris, France

Publication date: July 1, 2006

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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