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Tuberculosis and pericarditis in children
1Gweru Provincial Hospital, Midlands, Zimbabwe.
Insights
Tuberculosis (TB) poses a significant pediatric health challenge in Zimbabwe. Pericardial effusions in children should be considered indicative of TB due to high dissemination rates and diagnostic difficulties.
Area of Science:
- Pediatric infectious diseases
- Mycobacterial infections
- Public health epidemiology
Background:
- Tuberculosis (TB) is a growing pediatric health concern in Zimbabwe.
- Children face high risks for TB, disseminated disease, and diagnostic challenges.
- Unspecific symptoms and unknown contacts complicate pediatric TB diagnosis.
Purpose of the Study:
- To analyze data on pediatric tuberculosis cases in Gweru Hospital, Zimbabwe.
- To assess diagnostic yields and indicators of disseminated disease in children with TB.
- To inform clinical suspicion and diagnostic approaches for pediatric TB in high-incidence settings.
Main Methods:
- Retrospective analysis of data from 265 children treated for TB.
- Age range: 2 weeks to 12 years.
- Data collected in Gweru Hospital, Zimbabwe, in 1995.
Main Results:
- Pericardial effusion was identified in 72% of cases, indicating early dissemination.
- Mycobacterium tuberculosis cultures from gastric aspirates yielded positive results in 31% of cases.
- These culture yields are considered acceptable under limited resource conditions.
Conclusions:
- Pericardial effusion is a significant indicator of early disseminated TB in Zimbabwean children.
- Diagnostic yields for M. tuberculosis cultures are feasible even in resource-limited settings.
- Clinical suspicion for TB should be high in children presenting with pericardial effusions in Zimbabwe.
Abstract:
With the rapid spread of tuberculosis (TB) in Zimbabwe the disease is becoming a major paediatric health problem. Children are at high risk of TB, are prone to disseminated disease and the diagnosis of paediatric TB may be difficult, since complaints often are unspecific and contacts may not been known. Data from 265 children, aged between 2 weeks and 12 years, being treated for TB in Gweru Hospital in 1995, are analysed. In 72% pericardial effusion was found as a sign of early dissemination. Cultures of gastric aspirates for Mycobacterium tuberculosis were positive in 31%. In optimal circumstances the yield for isolates of M. tuberculosis is less than 50%, and these results under limited conditions are acceptable, and may reflect the true incidence. Given the epidemiology of TB in Zimbabwe, pericardial effusions should be considered indicative of TB until proven otherwise.