title: Criteria used for the diagnosis of childhood tuberculosis at primary health care level in a high-burden, urban setting.
abstract: BACKGROUND
  Children contribute a significant proportion of the total tuberculosis (TB) case load in high-burden settings and present a major diagnostic challenge.
  
  
  OBJECTIVE
  To document the criteria used at primary health care level to diagnose childhood TB in a high-burden, urban setting.
  
  
  METHODS
  This retrospective descriptive study was conducted at two primary health care clinics in Cape Town, South Africa. Information on all children (<15 years of age) entered into the TB register from January 2002 through December 2003 was retrieved for analysis.
  
  
  RESULTS
  During the study period, 1277 cases of TB were entered into the TB register, of which 268 (21.0%) were children. Information on 256 (95.5%) children was available for analysis. The majority (206, 80.5%) had intrathoracic TB, of whom 107 (51.5%) had uncomplicated lymph node disease, 79 (38.3%) complicated lymph node disease, 8 (3.9%) a pleural effusion and 12 (5.8%) adult-type cavitating disease. According to modified WHO criteria, the diagnosis of TB was confirmed in 27 (10.5%), probable in 193 (75.4%) and suspect in 36 (14.1%).
  
  
  CONCLUSIONS
  The diagnostic criteria used at primary health care level demonstrated good agreement with current guidelines, but depended heavily on chest radiograph interpretation.
authors.affiliation: Desmond Tutu TB Centre, Stellenbosch University, Cape Town, Western Cape, South Africa.
authors.forename: A C
authors.initials: AC
authors.lastname: Theart
authors.forename: B J
authors.initials: BJ
authors.lastname: Marais
authors.forename: R P
authors.initials: RP
authors.lastname: Gie
authors.forename: A C
authors.initials: AC
authors.lastname: Hesseling
authors.forename: N
authors.initials: N
authors.lastname: Beyers
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care; D012189:Retrospective Studies; D013019:South Africa; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology; D014505:Urban Population