title: Evaluation of Ziehl-Neelsen smear for diagnosis of pulmonary tuberculosis in childhood in a rural hospital in Ethiopia.
abstract: The goal of this study is to describe the experience with smear microscopy examination for acid-fast bacilli (AFB) of spontaneous sputum from children in a district hospital located in a rural zone of Ethiopia. All sputum reports of children were retrospectively reviewed from July 2007 until June 2012. During the period of study, 875 children less than 15years old were screened and 48 (5.5%, 95% confidence interval [CI]: 4.1-7.3%) were diagnosed with pulmonary tuberculosis sputum smear positive. The mean age of the children with sputum positive for AFB was significantly higher than children with sputum negative for AFB (11.4 versus 10.4) (p=0.001). Only 1 out of 47 (1.3%) children of 6years or less had sputum positive for AFB. In 13- and 14-year-old children, 8.7% had sputum positive for AFB (20 of 229) (p=0.03). Spontaneous sputum has a low diagnostic yield in childhood in low-income countries. Alternative methods should be implemented in rural areas to improve diagnosis of pulmonary TB, particularly in children less than 12years old.
authors.affiliation: Department of General Medicine and Paediatrics, Gambo General Rural Hospital, Shashemane, Ethiopia; Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain; Department of Medicine, Universidad Miguel Hernández de Elche, Spain. Electronic address: jramosrincon@yahoo.es.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Ramos
authors.affiliation: Department of Paediatrics, Hospital Universitario Infanta Leonor, Madrid, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Pérez-Butragueño
authors.affiliation: Department of General Medicine and Paediatrics, Gambo General Rural Hospital, Shashemane, Ethiopia.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Tisiano
authors.affiliation: Department of General Medicine and Paediatrics, Gambo General Rural Hospital, Shashemane, Ethiopia.
authors.forename: Tafese
authors.initials: T
authors.lastname: Yohannes
authors.affiliation: Department of General Medicine and Paediatrics, Gambo General Rural Hospital, Shashemane, Ethiopia.
authors.forename: Francisco
authors.initials: F
authors.lastname: Reyes
authors.affiliation: Department of General Medicine and Paediatrics, Gambo General Rural Hospital, Shashemane, Ethiopia; Division of Infectious Diseases, Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Górgolas
keywords: Childhood; Paediatric tuberculosis; Smear; Sputum; Tuberculosis