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Free Content Sputum induction for microbiological diagnosis of childhood pulmonary tuberculosis in a community setting

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SETTING: Sputum induction has increasingly enabled microbiological confirmation of pulmonary tuberculosis (PTB) in hospitalised children, but it has not been evaluated 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.
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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: September 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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