Tuberculosis in children at the Royal Hospital for Sick Children, Glasgow. January 1995-April 1998

The management of paediatric tuberculosis can be complicated. Since 1995, children referred to the Royal Hospital for Sick Children have been managed at a specialist tuberculosis clinic, in an attempt to standardise diagnosis, treatment and follow-up.

To review the management of paediatric tuberculosis at the Royal Hospital for Sick Children, Glasgow, from January 1995 to April 1998.

Retrospective study using information from the management database of all children treated for tuberculosis since January 1995.

Seventy two children have been treated (median age 5.9 [range 2.2-9.2] years; sex male:female 40:32; 76% Caucasians): 43 for tuberculosis disease, 21 for tuberculosis infection (chemoprophylaxis) and eight as tuberculosis contacts. Sixty three per cent were identified by contact tracing eighty one per cent of Mantoux tests were documented accurately. Of those with disease, 93% had gastric washings taken, and positive microbiological confirmation was obtained in 33%. All patients with disease were commenced on the chemotherapy regimen recommended by the British Thoracic Society. 88% completed treatment. Eighty four per cent of those with disease had been notified. Treatment of those in the infection or contact groups were treated more aggressively than the British Thoracic Society guidelines, with six months of treatment with isoniazid and rifampicin. Directly observed therapy was used in 17 children (24%). Only 53% of Indo-asian children had received BCG immunisation.

Most children were managed according to the British Thoracic Society guidelines. A management system, with a computerised database, has facilitated both patient management and audit, and ensured the delivery of quality care.