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A retrospective analysis of paediatric tuberculosis diagnosis in London: room for improvement?
  1. Tejshri Shah1,
  2. Bhanu Williams2,
  3. Daniel Langer3,
  4. Hannah Mitchell4,
  5. Andrea Togo5,
  6. Alexandra Y Kreins6,
  7. Laura Caddle1,
  8. Sreena Das2,
  9. Miranda Lutkin7,
  10. James A Seddon8
  1. 1Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, UK
  2. 2Department of Paediatrics, London North West Healthcare, London, UK
  3. 3Department of Paediatric Infectious Diseases, St. Mary's Hospital, London, UK
  4. 4Department of Paediatrics, The Whittington Hospital, London, UK
  5. 5Department of Paediatrics, St. George's Hopsital, London, UK
  6. 6Department of Paediatric Infectious Diseases, Evelina London Children's Hospital, London, UK
  7. 7Department of Paediatrics, Ealing Hospital, Southall, Middlesex, UK
  8. 8Department of Paediatrics, Imperial College, London, UK
  1. Correspondence to Dr Tejshri Shah; tejshri.shah{at}

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Tuberculosis (TB) in children can be challenging to diagnose with microbiological certainty. Younger children are unable to expectorate sputum and the bacillary load is frequently low; few children with a clinical diagnosis of pulmonary TB have this confirmed microbiologically. Similarly, confirmation of extra-pulmonary TB, using other samples, can be difficult.1

Despite these challenges, 27 TB guidelines, including those produced by the National Institute for Health and Care Excellence, recommend that microbiological confirmation is attempted in all children with suspected TB, and that where pulmonary TB is suspected, three samples should be sent.2 Microbiological diagnosis is useful for a number of reasons: it confirms the diagnosis, it allows epidemiological data regarding strain …

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  • Contributors TS and JAS conceived the study, developed the data collection tool, undertook data analysis and wrote the paper. BW, DL, HM, AT, AYK, LC, SD and ML contributed to data collection and critically reviewing the paper.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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