The prevalence of symptoms associated with pulmonary tuberculosis in randomly selected children from a high burden community
Date
2005-11
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
Background: Diagnosis of childhood tuberculosis is problematic and symptom based diagnostic
approaches are often promoted in high burden settings. This study aimed (i) to document the prevalence
of symptoms associated with tuberculosis among randomly selected children living in a high burden
community, and (ii) to compare the prevalence of these symptoms in children without tuberculosis to those
in children with newly diagnosed tuberculosis.
Methods: A cross sectional, community based survey was performed on a 15% random sample of
residential addresses. A symptom based questionnaire and tuberculin skin test (TST) were completed in all
children. Chest radiographs were performed according to South African National Tuberculosis Control
Program guidelines.
Results: Results were available in 1415 children of whom 451 (31.9%) were TST positive. Tuberculosis was
diagnosed in 18 (1.3%) children. Of the 1397 children without tuberculosis, 253 (26.4%) reported a
cough during the preceding 3 months. Comparison of individual symptoms (cough, dyspnoea, chest pain,
haemoptysis, anorexia, weight loss, fatigue, fever, night sweats) in children with and without tuberculosis
revealed that only weight loss differed significantly (OR = 4.5, 95% CI 1.5 to 12.3), while the combination
of cough and weight loss was most significant (OR = 5.4, 95% CI 1.7 to 16.9). Children with newly
diagnosed tuberculosis reported no symptoms in 50% of cases.
Conclusion: Children from this high burden community frequently reported symptoms associated with
tuberculosis. These symptoms had limited value to differentiate children diagnosed with tuberculosis from
those without tuberculosis. Improved case definitions and symptom characterisation are required when
evaluating the diagnostic value of symptoms.
Description
The original publication is available at http://adc.bmj.com/
Keywords
Citation
Marais, B. J. et al. 2005. The prevalence of symptoms associated with pulmonary tuberculosis in randomly selected children from a high burden community. Archives of Disease in Children, 90(11):116-1170, doi:10.1136/adc.2004.060640.