title: Radiological findings in young children investigated for tuberculosis in Mozambique.
abstract: BACKGROUND
  Chest radiography remains a critical tool for diagnosing intrathoracic tuberculosis (TB) in young children who are unable to expectorate. We describe the radiological findings in children under 3 years of age investigated for TB in the district of Manhiça, southern Mozambique, an area with a high prevalence of TB and HIV.
  
  
  METHODS
  Digital antero-posterior and lateral projections were performed and reviewed by two independent readers, using a standardized template. Readers included a local pediatrician and a pediatric radiologist blinded to all clinical information. International consensus case definitions for intra-thoracic TB in children were applied.
  
  
  RESULTS
  A total of 766 children were evaluated of whom 43 (5.6%) had TB. The most frequent lesion found in TB cases was air space consolidation (65.1%), followed by suggestive hilar lymphadenopathy (17.1%) and pleural effusion (7.0%). Air space consolidation was significantly more common in TB cases than in non-TB cases (odds ratio 8.9; 95% CI: 1.6-50.5), as were hilar lymphadenopathy (OR 17.2; 95% CI: 5.7-52.1). The only case with miliary infiltrates and 3 with pleural effusions occurred in HIV-infected children.
  
  
  CONCLUSIONS
  Frequent air space consolidation complicates radiological distinction between TB and bacterial pneumonia in young children, underscoring the need for epidemiological contextualization and consideration of all relevant signs and symptoms.
authors.affiliation: Centro de Investigação em Saude de Manhiça (CISM). Rua 12, Cambeve CP 1929 Maputo, Mozambique; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Rossello, 132, 08036, Barcelona, Spain.
authors.forename: Alberto L
authors.initials: AL
authors.lastname: García-Basteiro
authors.affiliation: Centro de Investigação em Saude de Manhiça (CISM). Rua 12, Cambeve CP 1929 Maputo, Mozambique; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Rossello, 132, 08036, Barcelona, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: López-Varela
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Rossello, 132, 08036, Barcelona, Spain.
authors.forename: Orvalho Joaquim
authors.initials: OJ
authors.lastname: Augusto
authors.affiliation: Centro de Investigação em Saude de Manhiça (CISM). Rua 12, Cambeve CP 1929 Maputo, Mozambique.
authors.forename: Kizito
authors.initials: K
authors.lastname: Gondo
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Rossello, 132, 08036, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Muñoz
authors.affiliation: Centro de Investigação em Saude de Manhiça (CISM). Rua 12, Cambeve CP 1929 Maputo, Mozambique.
authors.forename: Jahit
authors.initials: J
authors.lastname: Sacarlal
authors.affiliation: Marie Bashir Institute for Infectious Diseases and Biosecurity Institute (MBI) and The Children's Hospital at Westmead, The University of Sydney, Australia. Westmead NSW 2145 Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Marais
authors.affiliation: Centro de Investigação em Saude de Manhiça (CISM). Rua 12, Cambeve CP 1929 Maputo, Mozambique; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Rossello, 132, 08036, Barcelona, Spain.
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.affiliation: Radiology Department, Hospital San Juan de Dios. Passeig Sant Joan de Déu, 2. 08950 Esplugues de Llobregat, Barcelona, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Ribó
mesh_terms: D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015995:Prevalence; D011859:Radiography; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology