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Time to symptom resolution in young children treated for pulmonary tuberculosis

Nkosilesisa Mpofu1, Sizulu Moyo, Humphrey Mulenga

  • 1From the *South African Tuberculosis Vaccine Initiative (SATVI), Institute of Infectious Disease and Molecular Medicine (IIDMM); †School of Child and Adolescent Health, Faculty of Health Sciences, University of Cape Town; and ‡Division of Community Health, Stellenbosch University and Western Cape Government: Health, South Africa.

The Pediatric Infectious Disease Journal
|August 22, 2014
PubMed

Insights

In young children with suspected tuberculosis (TB), symptom resolution time after treatment does not reliably distinguish TB cases from non-cases. This finding impacts diagnostic trial criteria for pediatric TB.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Childhood tuberculosis (TB) diagnosis can be challenging.
  • Evaluating treatment response is considered for diagnostic confirmation.
  • Time to symptom resolution in pediatric pulmonary TB requires further investigation.

Purpose of the Study:

  • To assess the time to symptom resolution in children treated for pulmonary TB.
  • To determine if symptom resolution time can differentiate TB cases from non-cases in young children.

Main Methods:

  • A cohort of South African children under 2 years old with suspected pulmonary TB was analyzed.
  • Children were classified as TB cases or non-cases using a diagnostic algorithm.
  • Cox regression was used to identify determinants of symptom resolution.

Main Results:

  • Chest radiograph findings suggestive of TB were linked to longer symptom resolution times.
  • However, median durations for cough, wheeze, and failure to thrive did not significantly differ between TB cases and non-cases.
  • The majority of children experienced symptom resolution beyond 60 days of treatment.

Conclusions:

  • Symptom resolution time is not a reliable differentiator between TB cases and non-cases in young children.
  • Clinical response to treatment is not a suitable diagnostic criterion for pediatric TB trials.
  • Further research is needed for accurate diagnostic tools in pediatric TB.
Abstract

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