Tuberculosis in children and adolescents in the 1980s

Nemir, Rosa Lee; Krasinski, Keith

doi:10.1097/00006454-198806000-00001

Cited by 41 publications

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“…Many of the epidemiological characteristics of our patients are in agreement with those already known for Brussels or with the literature data [6,8,10,[14][15][16][17]. Though 85% of the patients were older than 3 years, 50% of the children under 3 years were symptomatic, confirming the fact that primary TBC is more severe in infancy.…”

Section: Discussionsupporting

confidence: 90%

Tuberculosis in children: a 13-year follow up of 1714 patients in a Belgian home care centre

et al. 1991

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From May 1970 to September 1983, 1714 children with different forms of primary tuberculosis were referred to the paediatric home care centre (Enfants soignés au Foyer, E.S.F.) of the Brussels University Hospital St.-Pierre. They were subdivided in five groups: asymptomatic (33%), symptomatic (28%), dubious tuberculous infections (35%), high-risk contacts (3%) and unestablished diagnosis (1%). They were aged from 10 days to 19 years, and 82% of them were migrants of low socio-economic level. Fifty percent of the symptomatic infections, mainly pulmonary, appeared in children under 3 years of age. An adult source of contamination was identified in 33% of the cases (48% of the symptomatic children). Diagnosis was based on tuberculin screening with a 2IU intradermal test. Gastric aspirates yielded Mycobacterium tuberculosis in 15% of our patients, 11% of them showing resistance to one or more tuberculostatic drugs. Treatment was given to 1359 patients with excellent results. Therapy was shortened during the last 2 years of the study from 12 to 6 months for the asymptomatic patients and from 12 to 9 months for the symptomatic infections. Few complications were observed. Tuberculosis remains a serious cause of morbidity particularly in migrant children. Correct diagnosis and treatment of the disease is very important.

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Section: Discussionsupporting

confidence: 90%

Tuberculosis in children: a 13-year follow up of 1714 patients in a Belgian home care centre

et al. 1991

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“…Erosion of caseating lesions into pulmonary vessels can result in haematogenous dissemination to the lung (miliary TB) and distant extrapulmonary sites. Older children and adolescents are more likely to develop adult-type reactivation disease or post-primary disease [Harris et al 1977;Nemir and Krasinski, 1988]. This follows infection acquired after 7 years of age, especially at the time of puberty [Lincoln et al 1960] and will present with the classic symptoms of fever, malaise, weight loss, night sweats, productive cough, chest pain and haemoptysis.…”

Section: Natural History and Clinical Featuresmentioning

confidence: 99%

Tuberculosis in childhood

Shingadia

2012

Ther Adv Respir Dis

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There has been a recent global resurgence of tuberculosis (TB) fuelled by HIV infection and migration. Childhood TB represents a sentinel event in the community, suggesting recent transmission from an infectious adult. The diagnosis of TB in children is based on chest X-ray, tuberculin skin testing and mycobacterial staining/culture, although the diagnostic yield from these investigations is often lower than in adults. Newer diagnostic tests are being developed and may improve the diagnostic yield in childhood TB. Treatment of TB in children is similar to adults in that short-course multidrug treatment has been adopted as standard therapy in many national TB programmes. Compliance is a major determinant of the success of drug treatment and directly observed therapy has been adopted as a key component of TB treatment programmes. Although uncommon in children, multidrug-resistant TB is also increasing and treatment often involves longer courses of therapy with second-line drugs.

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“…In the Western Cape, childhood TB has taken on epidemic proportions 1 . The disease is related to poor socioeconomic conditions such as overcrowding 2 , malnutrition, and, more recently, to HIV infection 1,3−5 . The diagnosis of pulmonary TB in children is often difficult because of a non‐specific clinical presentation, a non‐uniform clinical approach, the questionable value of skin and sputum tests, the non‐specific radiological signs and inter‐observer variation in the interpretation of radiographs 1,6 .…”

Section: Introductionmentioning

confidence: 99%

Specificity and sensitivity of chest radiographs in the diagnosis of paediatric pulmonary tuberculosis and the value of additional high‐kilovolt radiographs

Villiers

Andronikou

Westhuizen

2004

Australasian Radiology

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Tuberculosis (TB) remains the most common notifiable infectious disease in South Africa. The diagnosis of pulmonary TB in children is often very difficult because of the non-specific radiological signs and inter-observer variation in the interpretation of radiographs. The frontal high-kilovolt (kV) radiograph has been used to assess the effect of TB adenopathy on the tracheobronchial tree and to detect endobronchial lesions. The aims of the present study were to assess the specificity and sensitivity of chest radiographs in the diagnosis of pulmonary TB and to assess whether the addition of the high-kV radiograph affects these parameters. The study group consisted of paediatric patients suspected of having pulmonary TB over a 6-year period. These patients had clinical, bacteriological and radiographic examinations. Radiographs were examined by one experienced radiologist in two sittings separated by a 6-week interval. On the first sitting, only standard radiographs were examined and, on the second sitting, these were supplemented with high-kV radiographs. Differences in the detection of each recognized radiological feature of pulmonary TB before and after the addition of the high-kV film were analysed for statistical significance. The frequency of radiographic findings in our study compared favourably with other reports. No statistically significant differences for the detection of radiographic features consistent with pulmonary TB, or for the diagnosis of pulmonary TB, were demonstrated between the two sittings. Specificity increased from 74.4% to 86.6% with the addition of the high-kV view and sensitivity remained constant at 38.8%. The present study does not support the routine use of the frontal high-kV radiograph for the diagnosis of pulmonary TB. This paper also confirms the findings of others, that standard chest radiographs are a poor indicator of pulmonary TB in children.

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Tuberculosis in children and adolescents in the 1980s

Cited by 41 publications

References 0 publications

Tuberculosis in children: a 13-year follow up of 1714 patients in a Belgian home care centre

Tuberculosis in children: a 13-year follow up of 1714 patients in a Belgian home care centre

Tuberculosis in childhood

Specificity and sensitivity of chest radiographs in the diagnosis of paediatric pulmonary tuberculosis and the value of additional high‐kilovolt radiographs

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