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TB IN CHILDREN
There has been a resurgence of tuberculosis (TB) in children in many countries. Howie et al describe a tripling in the annual incidence of TB in New Zealand children between 1992 and 2000. The vast majority of cases were associated with social deprivation. Marais and colleagues, from South Africa, describe symptoms associated with the diagnosis of TB in 16 children. Fatigue and a non-remitting cough were far more common in these children than a group of 135 children without TB. Lastly, the interpretation of chest x rays is critical to the diagnosis of TB – is mediastinal lymphadeonopathy present? Swingler and colleagues, once again from South Africa, compare the interpretation of the x ray by three paediatricians and three primary care clinicians. The gold standard is spiral chest CT with contrast interpreted by a radiologist blind to the chest x ray. Not surprisingly, neither the sensitivity, 67%, nor specificity, 59%, …
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