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An evaluation of the completeness of reporting of childhood tuberculosis

S S S Teo1, M Alfaham, M R Evans

  • 1Centre for Child Health, University of London, London, UK.

The European Respiratory Journal
|March 3, 2009
PubMed

Insights

The Enhanced Tuberculosis Surveillance (ETS) scheme significantly under-reports childhood tuberculosis cases, particularly in children under five. Improved reporting is crucial for accurate public health planning and resource allocation.

Area of Science:

  • Public Health
  • Epidemiology
  • Pediatrics

Background:

  • The sensitivity of the Enhanced Tuberculosis Surveillance (ETS) scheme for monitoring pediatric tuberculosis in the UK is not well-established.
  • Accurate surveillance data is essential for effective public health interventions and resource allocation for tuberculosis control.

Purpose of the Study:

  • To evaluate the sensitivity of the Enhanced Tuberculosis Surveillance (ETS) scheme in capturing pediatric tuberculosis cases in the UK.
  • To identify demographic factors influencing reporting rates within the ETS scheme.

Main Methods:

  • A prospective observational study was conducted using the British Paediatric Surveillance Unit (BPSU) reporting scheme.
  • Paediatric tuberculosis cases reported to the BPSU between January and December 2004 were matched with records from the ETS database.
  • Sensitivity was assessed by comparing case ascertainment between the two surveillance systems.

Main Results:

  • Out of 320 cases reported to the BPSU, an estimated 557 pediatric tuberculosis cases occurred in England, Wales, and Northern Ireland in 2004.
  • 40% of cases were reported to both BPSU and ETS, 18% to BPSU only, and 42% to ETS only.
  • Children under 5 years were significantly less likely to be reported to ETS compared to older children (p<0.01).

Conclusions:

  • There is substantial under-reporting of childhood tuberculosis, with the ETS missing approximately 20% of cases.
  • The ETS scheme may miss a disproportionately higher number of tuberculosis cases in children under 5 years.
  • Enhanced efforts are required to improve the completeness of the ETS for pediatric tuberculosis surveillance and inform resource allocation.

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