title: Pulmonary TB bacteriologically confirmed by induced sputum among children at Bugando Medical Centre, Tanzania.
abstract: BACKGROUND
  The diagnosis of paediatric tuberculosis (TB) remains difficult in resource-: poor settings.
  
  
  OBJECTIVE
  To evaluate induced sputum collection and examination using microscopy, culture and Xpert(®) MTB/RIF assay for the diagnosis of pulmonary TB (PTB) in a Tanzanian hospital vs. PTB diagnosis using clinical scoring tools alone.
  
  
  METHODS
  We conducted a cross-sectional study from October 2013 to April 2014 at our hospital in northwestern Tanzania. Children presumed to have TB were assessed using four TB score charts and sputum examination. Sputum samples were analyzed using fluorescence microscopy, solid culture and Xpert. The number of cases microbiologically confirmed was compared to the number of TB cases suspected based on TB score charts.
  
  
  RESULTS
  A total of 192 patients were enrolled. Sputum specimens were successfully obtained in 187 (97.4%) patients without any major complications. Ten (5.2%) children were confirmed to have PTB by sputum examination. More than half (50-90%) of the confirmed cases were not detected by score charts alone.
  
  
  CONCLUSIONS
  Sputum induction is both safe and feasible in a severely resource-limited hospital, and can lead to microbiological PTB diagnosis that would not be detected by clinical criteria alone.
authors.affiliation: Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania; Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania.
authors.forename: I
authors.initials: I
authors.lastname: Sabi
authors.affiliation: Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania; Bugando Medical Centre, Mwanza, Tanzania.
authors.forename: R
authors.initials: R
authors.lastname: Kabyemera
authors.affiliation: Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania.
authors.forename: S E
authors.initials: SE
authors.lastname: Mshana
authors.affiliation: Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania.
authors.forename: B R
authors.initials: BR
authors.lastname: Kidenya
authors.affiliation: Bugando Medical Centre, Mwanza, Tanzania.
authors.forename: G
authors.initials: G
authors.lastname: Kasanga
authors.affiliation: Bugando Medical Centre, Mwanza, Tanzania.
authors.forename: L E
authors.initials: LE
authors.lastname: Gerwing-Adima
authors.affiliation: School of Medicine of the University of Dodoma, Dodoma, Tanzania.
authors.forename: A
authors.initials: A
authors.lastname: Meremo
authors.affiliation: Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania; Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Clowes
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Rachow
authors.affiliation: Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania; Bugando Medical Centre, Mwanza, Tanzania; Weill Cornell Medical College, New York, New York, USA.
authors.forename: R N
authors.initials: RN
authors.lastname: Peck
mesh_terms: D000367:Age Factors; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007297:Inpatients; D008297:Male; D008856:Microscopy, Fluorescence; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D011379:Prognosis; D013183:Sputum / Q000382:microbiology; D013636:Tanzania; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology