title: Diagnostic approach of childhood pulmonary tuberculosis in endemic areas of Southeast Nigeria.
abstract: There is the need to ascertain the diagnostic approach on which medical doctors based their diagnosis of childhood pulmonary tuberculosis especially in tuberculosis endemic areas.
  
  
  OBJECTIVE
  To determine the diagnostic approach used by medical doctors in the diagnosis of childhood pulmonary tuberculosis.
  
  
  METHODS
  A cross sectional study, using structured questionnaires to collect data from medical doctors whose daily routine include seeing sick children was carried out.
  
  
  RESULTS
  The common diagnostic approach or criteria were ranked by medical doctors in descending order of importance as follows; clinical features elicited from patients' history was ranked-1 by 56.4% (or 23 of 218); bacteriological investigation to isolate Mycobacterium Tuberculosis was ranked-2 by 22.5% or 49 of 218; radiological investigation to demonstrate typical changes consistent with active pulmonary tuberculosis was ranked-3 by 25.2% or 55 of 218; therapeutic trial with standard anti tuberculosis drugs was ranked-4 by 52.3% or 114 of 218; immunological investigation using tuberculin skin testing was ranked-5 by 30.3% or 66 of 218; and residual ranking of histological investigation using tissue biopsy was ranked-6 by 15.6% or 34 of 218. Therapeutic trial with standard anti tuberculosis drugs was consistently ranked as 4th by most groups of clinicians.
  
  
  CONCLUSIONS
  Most clinicians from different subgroups studied followed a fairly similar order in the diagnosis of childhood pulmonary tuberculosis with a high premium placed on clinical features, bacteriologic, radiologic and therapeutic trial with anti tuberculosis drugs. The specialist in paediatric medicine relied more on clinical features and therapeutic trials for their diagnosis of childhood pulmonary tuberculosis.
authors.affiliation: Dept. of Primary Health Care, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Anambra State of Nigeria. godwsilln@yahoo.co.uk
authors.forename: G A
authors.initials: GA
authors.lastname: Nnaji
authors.forename: J
authors.initials: J
authors.lastname: Chukwu
authors.forename: E F
authors.initials: EF
authors.lastname: Ugochukwu
authors.forename: C
authors.initials: C
authors.lastname: Ezechukwu
authors.forename: L
authors.initials: L
authors.lastname: Ogbonnaya
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009549:Nigeria / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology