The epidemiology and diagnosis of childhood tuberculosis at a district hospital in Kwazulu-Natal, South Africa : a retrospective audit of clinical practice

Includes bibliographical references.TB was declared a priority disease in South Africa ten years ago. Despite efforts to manage this illness, South Africa ranks as one of 22 high burden countries globally. TB is an important cause of childhood morbidity and mortality, but much of the emphasis of the NTP is on smear positive (adult) TB, as this is perceived to be the greater public health problem. The presence of HIV infection exacerbates both the incidence of TB, and the progress of TB from infection to the development of disease in both children and adults. The diagnosis of childhood TB has proved to be difficult and continues to challenge clinicians, despite technological advances in various spheres of medicine. Several guidelines and recommendations are available for diagnosing TB in children, including combinations of clinical criteria, special investigations, laboratory methods and score systems, but no gold standard exists.It is not clear how well the SANTCP guidelines for diagnosis of childhood TB are being implemented at Emmaus Hospital, or whether these guidelines are still appropriate within the context of high HIV prevalence. Not enough is known about the epidemiology of childhood TB in the Okhahlamba local municipal area surrounding Emmaus hospital to guide optimal management of children. Given the likely magnitude of the problem of childhood TB in this rural area and the difficulties of diagnosis, research into the epidemiology and diagnosis of childhood TB in this context is necessary