Article
Sputum induction for the diagnosis of pulmonary tuberculosis in
infants and young children in an urban setting in South Africa
H J Zar, E Tannenbaum, P Apolles, P Roux, D Hanslo, G Hussey
Department of
Paediatrics and Child Health, Red Cross War Memorial Children's
Hospital, University of Cape Town, South Africa
Correspondence to: Dr H Zar, Child Health Unit, 46 Sawkins Road, Rondebosch, 7700, South Africa email: heather{at}rmh.uct.ac.za
Accepted 24 November
1999
BACKGROUND
Bacteriological
confirmation of pulmonary tuberculosis is difficult in infants and
young children. In adults and older children, sputum induction has been
successfully used; this technique has not been tested in younger children.
AIMSTo investigate
whether sputum induction can be successfully performed in infants and
young children and to determine the utility of induced sputum compared
to gastric lavage (GL) for the diagnosis of pulmonary tuberculosis in
HIV infected and uninfected children.
SUBJECTS AND
METHODS149 children (median age 9 months)
admitted to hospital with acute pneumonia who were known to be HIV
infected, suspected to have HIV infection, or required intensive care
unit support. Sputum induction was performed on enrolment. Early
morning GL was performed after a minimum four hour fast. Induced
sputum and stomach contents were stained for acid fast bacilli and
cultured for Mycobacterium
tuberculosis.
RESULTSSputum
induction was successfully performed in 142 of 149 children.
M tuberculosis, cultured in 16 children, grew from induced sputum in 15. GL, performed in 142 children, was positive in nine; in eight of these M
tuberculosis also grew from induced sputum. The
difference between yields from induced sputum compared to GL was 4.3%
(p = 0.08). M tuberculosis
was cultured in 10 of 100 HIV infected children compared to six of 42 HIV uninfected children (p = 0.46).
CONCLUSIONSputum
induction can be safely and effectively performed in infants and young
children. Induced sputum provides a satisfactory and more convenient
specimen for bacteriological confirmation of pulmonary tuberculosis in
HIV infected and uninfected children.
Keywords: induced sputum; tuberculosis; HIV
© 2000 by Archives of Disease in Childhood
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eLetters:
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- Sputum induction not more sensitive than gastric lavage
- H E Wiersma
- ADC Online, 2 Jun 2000 [Full text]
- Re: Sputum induction not more sensitive than gastric lavage
- Heather J Zar
- ADC Online, 8 Jun 2000 [Full text]
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