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Published on: August 11, 2008
Patterns of Childhood Tuberculosis Diagnosis in Hawassa University Comprehensive Specialized Hospital, Hawassa,
Kefyalew Taye1, Nagasa Tolesa1,2, Agete Tadewos3
1Department of Pediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Insights
Diagnosing childhood tuberculosis (TB) is challenging due to sample collection difficulties. Over half of children were treated based on clinical signs alone, highlighting the need for improved microbiological diagnostic methods for accurate TB management.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Childhood tuberculosis (TB) diagnosis is difficult due to paucibacillary nature and challenges in obtaining sputum samples from children.
- Early identification and treatment are crucial as childhood TB progresses rapidly.
Purpose of the Study:
- To determine the diagnostic patterns for all forms of childhood tuberculosis at Hawassa University Comprehensive Specialized Hospital in Ethiopia.
Main Methods:
- A retrospective cross-sectional study was conducted from February 2017 to January 2021.
- Data were extracted from medical charts and logbooks of 175 children diagnosed and treated for TB.
- Statistical analysis was performed using SPSS version 23.0.
Main Results:
- Fever (94.9%), weight loss (88%), and cough (77.7%) were the leading clinical symptoms.
- Diagnostic test positivity varied: Xpert MTB/Rif on gastric aspirate (30.6%), FNAC (7.5%), CSF analysis (28.8%), smear microscopy (34.5%), and chest X-ray (43.2%).
Conclusions:
- Over half (51%) of children received TB treatment based solely on clinical criteria, risking underestimation and mistreatment.
- Improved microbiological diagnosis is essential for accurate childhood TB management.
- Expanded availability and use of sensitive and specific diagnostic techniques are recommended.
Background:
Because of the pauci bacillary nature of childhood tuberculosis and the difficulties in obtaining proper sputum samples from young children, diagnosing childhood tuberculosis (TB) is difficult. Childhood TB needs early identification and care since it advances swiftly to more advanced stages. This study was aimed to determine the patterns of all forms of childhood tuberculosis diagnosis at Hawassa University Comprehensive Specialized Hospital in Hawassa, Ethiopia.
Methods:
A retrospective cross-sectional study was conducted from February 1, 2017 to January 30, 2021 among 175 children diagnosed and treated for tuberculosis in the pediatric ward. Children medical charts and pediatrics ward logbook were used to extract pertinent data by structured checklists. SPSS version 23.0 was used for data entry and statistical analysis.
Results:
Of 175 children, fever was the leading clinical symptoms and diagnosed in 166 (94.9%) children followed by weight loss (154, 88%), and cough (136, 77.7%). In twenty seven out of 88 (30.6%) children, gastric aspirate was positive for TB infection by Xpert MTB/Rif, while 3/40 (7.5%) were positive for TB using fine needle aspiration cytology (FNAC), 19/66 (28.8%) had suggestive TB by cerebrospinal fluid analysis (CSF), 10/29 (34.5%) were smear positive for TB and 70/162 (43.2%) were suspected for TB by chest X-ray.
Conclusion:
Despite recent breakthroughs in quick microbiological detection, such as Xpert MTB/Rif, this study revealed that more than half of the children, 89/175 (51%), were treated for TB diseases solely based on clinical criteria. This will significantly underestimate the true nature of the illness or disease and make them vulnerable to mistreatment. As a result, in order to appropriately treat the disease and manage patients in our settings, getting a microbiological diagnosis of childhood tuberculosis requires improvement, and we call for expanded availability and use of a more sensitive and specific diagnostic technique to circumvent these concerns.
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