title: The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV.
abstract: Bronchoscopy, an important investigation for the diagnosis and management of respiratory diseases, is widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC).
  
  
  
  Aim was to describe the indications, findings and complications of bronchoscopy in a middle income country with a high prevalence of tuberculosis and HIV.
  
  
  
  A retrospective analysis of a database over a 3.5 year period.
  
  
  
  A total of 509 bronchoscopies were performed on neonates (2.3%) and children (median age = 18 months) of which 5.1% were HIV-infected. The main indications were: possible large airway compression 40%, complicated pneumonia (25%) and persistent stridor (15%). Pathology was observed in 64% of bronchoscopies. The most findings were lymph node compression of the airways (21%), and upper airway pathology (12%). Interventional procedures were performed in 112 cases (22%), the commonest being foreign bodies removal (30%), endobronchial lymph node enucleation (30%) and transbronchial needle aspiration (20%). No major complications.
  
  
  
  The diagnostic yield of paediatric bronchoscopy did not differ from high income countries emphasising the importance of paediatric bronchoscopy in the management of childhood lung disease in LMICs.
authors.affiliation: a Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University and Tygerberg Children's Hospital , Cape Town , South Africa.
authors.forename: Irwin
authors.initials: I
authors.lastname: Webster
authors.affiliation: a Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University and Tygerberg Children's Hospital , Cape Town , South Africa.
authors.forename: Pierre
authors.initials: P
authors.lastname: Goussard
authors.affiliation: a Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences , Stellenbosch University and Tygerberg Children's Hospital , Cape Town , South Africa.
authors.forename: Robert
authors.initials: R
authors.lastname: Gie
authors.affiliation: b Department of Cardio-Thoracic Surgery, Faculty of Medicine and Health Sciences , Stellenbosch University and Tygerberg Children's Hospital , Cape Town , South Africa.
authors.forename: Jacques
authors.initials: J
authors.lastname: Janson
authors.affiliation: b Department of Cardio-Thoracic Surgery, Faculty of Medicine and Health Sciences , Stellenbosch University and Tygerberg Children's Hospital , Cape Town , South Africa.
authors.forename: Gawie
authors.initials: G
authors.lastname: Rossouw
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis*; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000175:diagnosis*; D015995:Prevalence; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000473:pathology
keywords: Bronchoscopy; HIV; complicated pneumonia; foreign body aspiration; interventional bronchoscopy; pediatric intensive care; pulmonary tuberculosis; stridor