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Updated: Apr 3, 2026
An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis
Published on: August 16, 2021
Incomplete registration and reporting of culture-confirmed childhood tuberculosis diagnosed in hospital
K du Preez1, H S Schaaf1, R Dunbar1
1Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
Insights
Many children with confirmed tuberculosis (TB) diagnosed at a referral hospital were not registered in South Africa's electronic TB register (ETR.Net). This underreporting significantly impacts the accurate surveillance of childhood TB.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- The South African National Tuberculosis Programme (NTP) mandates TB patient registration at community clinics.
- Childhood TB is often diagnosed at referral hospitals, raising concerns about accurate reporting within the NTP.
- Underreporting may lead to an incomplete understanding of the childhood TB burden and severity.
Purpose of the Study:
- To evaluate the completeness of childhood tuberculosis (TB) registration in the provincial electronic TB register (ETR.Net).
- To assess the accuracy of TB patient data for children diagnosed at a referral hospital.
- To describe the treatment outcomes for children diagnosed with culture-confirmed TB.
Main Methods:
- A retrospective cohort study was conducted involving children under 13 years old diagnosed with culture-confirmed TB at Tygerberg Children's Hospital (July 2007-June 2009).
- Hospital data were collected for demographic, clinical, and referral factors.
- Electronic matching was employed to link hospital records with the provincial ETR.Net database.
Main Results:
- Only 62% (166 of 267) of children diagnosed with TB were registered in ETR.Net.
- Children with TB meningitis and those who died before referral were less likely to be registered.
- Treatment outcome data were available for 70% of cases, with favorable outcomes reported in 56%.
Conclusions:
- A significant proportion of children with confirmed TB diagnosed at a referral hospital were not registered in the ETR.Net system.
- This underreporting leads to an underestimated burden and severity of childhood TB.
- Integrating hospital data into routine surveillance is crucial for accurate childhood TB monitoring.
Setting:
The South African National Tuberculosis Programme (NTP) recommends the registration of tuberculosis (TB) patients at community clinics. TB in children is often diagnosed at referral hospitals, and there are concerns as to whether these children are accurately reflected in routine NTP reporting.
Objective:
To assess the completeness of registration of children with culture-confirmed TB diagnosed in a referral hospital, in the routine provincial electronic TB register (ETR.Net), and to describe TB treatment outcomes.
Design:
A retrospective cohort study including children aged <13 years diagnosed with culture-confirmed TB at Tygerberg Children's Hospital from July 2007 to June 2009. Data on demographic, clinical and referral factors were collated from hospital data sources. Electronic matching was used to identify children in the provincial ETR.Net.
Results:
Only 166 of 267 (62%) children were registered in ETR.Net. Children with TB meningitis and death prior to referral were significantly less likely to be registered. Treatment outcome data were available for only 70% of children; favourable outcomes were reported in 56%.
Conclusions:
A large proportion of children diagnosed with confirmed TB at a referral hospital were not registered, resulting in underreporting of the burden and severity of childhood TB. Routine surveillance of childhood TB should include linkage of hospital data.
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