A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Medicine (Child Health Community Paediatrics)
Johannesburg 2014 / Study Aim: To identify the criteria used to diagnose childhood tuberculosis (TB) at two paediatric outpatient departments in Johannesburg between 01 November 1997 and 30 June 1998 and to compare the criteria used to those used by the World Health Organization in the diagnosis of childhood TB.
Study Design: An observational descriptive, retrospective, hospital outpatient-based study.
Setting: Paediatric outpatient departments of Coronation Hospital (CH) and Johannesburg General Hospital (JGH).
Patients and Methods: Patients ranging from the ages of 3 months to 14 years who attended the two paediatric outpatient departments and were diagnosed and notified as having TB, comprised the study population. Criteria used to establish the diagnosis of TB for each patient were extracted from patient records. Clinical history and baseline clinical characteristics were analysed using standard statistical methods, and criteria used to make a diagnosis of tuberculosis were compared to those recommended by the World Health Organization.
Results: One hundred and one patients were diagnosed with TB at the two outpatient departments during the eight month study period. The combination of symptoms suggestive of active TB, which included persistent cough >1 month associated with fever, weight loss and loss of appetite, was more common in the JGH cohort (32 of 51 patients;
63%) compared to the CH cohort (10 of 50 patients; 20%); Odds Ratio (OR) 6.74 (95% Confidence Interval [CI], 2.54-18.41), P<0.001.
One third (32%) of the total group of children had a positive TB exposure history.
Tuberculin skin test (TST) reactions were positive in 86% of the total cohort, with a similar result being seen at both hospitals.
Submission of specimens for microbiological assessment was not a common practice in either outpatient department, with 95% (96 of 101 participants) not having any specimens collected.
Overall, 93% (94 of 101 participants) were classified as having ‘Probable’ TB.
Conclusion: Criteria being used to diagnose childhood TB in the two paediatric outpatient departments are comparable to the WHO criteria recommended for the diagnosis of childhood TB. The majority of children diagnosed were classified as ‘Probable’ TB. TST was the main diagnostic tool used in the two outpatient departments at the time of study conduct.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17509 |
| Date | 22 April 2015 |
| Creators | Nalumango, Johanna Jedida |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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