Age-related tuberculosis incidence and severity in children under 5 years of age in Cape Town, South Africa.
METHODS
Limited data are available on the characteristics of tuberculosis (TB) disease in young children, especially in high-burden countries.


OBJECTIVE
To assess the incidence and severity of TB in children aged <5 years.


METHODS
TB records and chest radiographs of children born in Cape Town in 1999 and diagnosed with TB between 1999 and 2004 were reviewed retrospectively.


RESULTS
A total of 1607 cases were registered. The cumulative incidence of definite (bacteriologically confirmed) and probable (radiological evidence and > or =1 TB clinical feature) TB in children aged <5 years was 2.9% and was highest between the ages of 12 and 23 months. Of 1233 children with definite or probable TB, 506 (41%) had severe disease (dissemination, cavities or >1 lobe involved). The under 5 years incidence of disseminated TB was 0.33%. Of 239 (15%) cases that were bacteriologically confirmed, clinical features typical of TB disease were individually present in <60%. The most common combined symptoms were cough for >2 weeks and weight loss, occurring in 43/239 (18%).


CONCLUSIONS
TB incidence was high, and peaked in children aged 12-23 months. Many children experienced severe disease. A fifth of children with microbiologically confirmed disease presented with only one feature typically associated with TB.
Moyo
S
S
South African Tuberculosis Vaccine Initiative, University of Cape Town, Cape Town, South Africa. sizulu.moyo@uct.ac.za
Verver
S
S
Mahomed
H
H
Hawkridge
A
A
Kibel
M
M
Hatherill
M
M
Tameris
M
M
Geldenhuys
H
H
Hanekom
W
W
Hussey
G
G
D017677:Age Distribution; D002675:Child, Preschool; D003371:Cough / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology / Q000503:physiopathology*; D015431:Weight Loss