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Haematological abnormalities in children with tuberculosis
G Wessels1, H S Schaaf, N Beyers
1Department of Paediatrics and Child Health, Tygerberg Hospital, South Africa.
Insights
A full blood count (FBC) has no diagnostic value for childhood tuberculosis (TB). While anaemia and elevated white blood cells are common in TB patients, these findings also appear frequently in children with other respiratory infections.
Area of Science:
- Pediatrics
- Hematology
- Infectious Diseases
Background:
- Tuberculosis (TB) diagnosis in children remains challenging, particularly in developing countries.
- Hematological parameters are often evaluated to aid in diagnosis, but their utility in pediatric TB requires further investigation.
Purpose of the Study:
- To evaluate the diagnostic predictive value of a full blood count (FBC) in children suspected of having tuberculosis (TB).
- To identify specific hematological parameters that differentiate TB cases from non-TB cases in pediatric populations.
Main Methods:
- A retrospective study of 307 children with suspected TB and available FBC results at Tygerberg Hospital, South Africa.
- Children were categorized into confirmed TB (Group A), probable TB (Group B), and no TB (Group C) based on WHO criteria.
- Statistical analysis compared hematological parameters, including hemoglobin, white blood cell counts, and differentials, between groups.
Main Results:
- Lower mean hemoglobin (Hb) was the only significant difference between children with TB (Groups A & B) and the no-TB group (Group C).
- No significant differences were observed in total white cell count, neutrophils, lymphocytes, monocytes, or platelets between groups.
- Common abnormalities like anemia, neutrophilia, and monocytosis were found with equal frequency in both TB and non-TB children.
Conclusions:
- A full blood count (FBC) does not possess diagnostic predictive value for investigating childhood tuberculosis.
- Hematological abnormalities are common in pediatric TB but are also prevalent in children with other respiratory infections in developing countries.
- Relying solely on FBC results is insufficient for diagnosing TB in children, necessitating further diagnostic approaches.
Abstract:
Over a 16 month period 307 children with suspected tuberculosis (TB) and an available full blood count (FBC) seen at Tygerberg Hospital in South Africa were evaluated and categorized as confirmed (A), probable (B), and no TB (C) according to WHO criteria. There was no difference in the mean age of the 168 group A (33.6 months), 83 group B (34.4 months), and the 56 group C (31.6 months) children. A lower mean haemoglobin (Hb 10.2 vs. 10.8 g/dl) was the only significantly different haematological parameter in children with TB compared with the comparison group (Group C). There were no differences in median total white cell count, neutrophils, lymphocytes, monocytes, platelets, or the proportion of children in each group with anaemia, microcytosis, neutrophilia, neutropenia, lymphocytosis, lymphopenia, monocytosis, thrombocytosis or thrombocytopenia. The most common haematological abnormalities in children with TB were the presence of anaemia, neutrophilia, and monocytosis but these changes were found with equal frequency in control patients. Although haematological abnormalities are fairly common in children with TB, in a developing country these abnormalities also occur frequently in children with other non-tuberculosis respiratory infections. An FBC has no diagnostic predictive value when investigating a child for TB.