title: Time to symptom resolution in young children treated for pulmonary tuberculosis.
abstract: BACKGROUND
  Response to treatment may be useful for diagnostic confirmation of childhood tuberculosis (TB). We aimed to evaluate time to symptom resolution in children treated for pulmonary TB.
  
  
  METHODS
  We compared pulmonary TB cases and noncases, classified by a published diagnostic algorithm, in South African children younger than 2. TB treatment was prescribed independently on clinical grounds. We analyzed independent determinants of baseline symptom resolution by Cox regression.
  
  
  RESULTS
  One hundred and ninety-one symptomatic children, median age 12 months, were prescribed for TB treatment. Chest radiograph features of TB were associated with longer time to resolution of cough (adjusted hazard ratio, AHR 0.31), wheeze (AHR 0.26) and failure to thrive (AHR 0.41), (all P < 0.05). However, median duration of baseline cough (63 vs. 70 days, P = 0.98), wheeze (62 vs. 68 days, P = 0.87) and failure to thrive (76 vs. 66 days, P = 0.59) did not differ in TB cases (n = 48) versus noncases (n = 46).
  
  
  CONCLUSIONS
  Baseline symptoms take more than 60 days to resolve in the majority of young children after starting TB treatment. Furthermore, since time to resolution does not differentiate TB cases from noncases; clinical response to treatment is not an appropriate diagnostic criterion for pediatric trials of TB diagnostics, drugs and vaccines.
authors.affiliation: From the *South African Tuberculosis Vaccine Initiative (SATVI), Institute of Infectious Disease and Molecular Medicine (IIDMM); †School of Child and Adolescent Health, Faculty of Health Sciences, University of Cape Town; and ‡Division of Community Health, Stellenbosch University and Western Cape Government: Health, South Africa.
authors.forename: Nkosilesisa
authors.initials: N
authors.lastname: Mpofu
authors.forename: Sizulu
authors.initials: S
authors.lastname: Moyo
authors.forename: Humphrey
authors.initials: H
authors.lastname: Mulenga
authors.forename: Kany Kany A
authors.initials: KK
authors.lastname: Luabeya
authors.forename: Michele
authors.initials: M
authors.lastname: Tameris
authors.forename: Hennie
authors.initials: H
authors.lastname: Geldenhuys
authors.forename: Gregory
authors.initials: G
authors.lastname: Hussey
authors.forename: Thomas
authors.initials: T
authors.lastname: Scriba
authors.forename: Willem
authors.initials: W
authors.lastname: Hanekom
authors.forename: Hassan
authors.initials: H
authors.lastname: Mahomed
authors.forename: Mark
authors.initials: M
authors.lastname: Hatherill
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013019:South Africa; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents