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Radiological findings in young children investigated for tuberculosis in Mozambique

Alberto L García-Basteiro1, Elisa López-Varela1, Orvalho Joaquim Augusto2

  • 1Centro de Investigação em Saude de Manhiça (CISM). Rua 12, Cambeve CP 1929 Maputo, Mozambique; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Rossello, 132, 08036, Barcelona, Spain.

Plos One
|May 29, 2015
PubMed

Insights

Chest radiography is vital for diagnosing intrathoracic tuberculosis (TB) in young children. Air space consolidation is a common finding, often mimicking bacterial pneumonia, highlighting the need for clinical context.

Area of Science:

  • Pediatric Radiology
  • Infectious Diseases
  • Public Health

Background:

  • Chest radiography is essential for diagnosing intrathoracic tuberculosis (TB) in non-expectorating young children.
  • High prevalence of TB and HIV in Manhiça, Mozambique, necessitates accurate diagnostic tools for children under 3.

Purpose of the Study:

  • To describe radiological findings in children under 3 years investigated for intrathoracic TB.
  • To evaluate the utility of chest radiography in diagnosing childhood TB in a high-prevalence area.

Main Methods:

  • Digital antero-posterior and lateral chest X-rays were reviewed by two independent readers using a standardized template.
  • International consensus case definitions for intra-thoracic TB in children were applied.
  • Pediatrician and pediatric radiologist readers were blinded to clinical information.

Main Results:

  • Out of 766 children, 43 (5.6%) had TB. Air space consolidation was the most frequent finding (65.1%), significantly more common in TB cases.
  • Hilar lymphadenopathy (17.1%) and pleural effusion (7.0%) were also observed. Miliary infiltrates and pleural effusions were noted in HIV-infected children.
  • Air space consolidation showed an odds ratio of 8.9 for TB, and hilar lymphadenopathy an OR of 17.2.

Conclusions:

  • Frequent air space consolidation on chest X-rays complicates the differentiation between TB and bacterial pneumonia in young children.
  • Epidemiological context and comprehensive clinical evaluation are crucial for accurate TB diagnosis in this population.
  • Radiological findings must be interpreted alongside clinical signs and symptoms for effective management.
Abstract

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