PT - JOURNAL ARTICLE AU - Verghese Mathew AU - Mazin Alfaham AU - Meirion R Evans AU - Haydn Adams AU - Roger Verrier Jones AU - Ian Campbell AU - Tony Jenkins TI - Management of tuberculosis in Wales: 1986–92 AID - 10.1136/adc.78.4.349 DP - 1998 Apr 01 TA - Archives of Disease in Childhood PG - 349--353 VI - 78 IP - 4 4099 - http://adc.bmj.com/content/78/4/349.short 4100 - http://adc.bmj.com/content/78/4/349.full SO - Arch Dis Child1998 Apr 01; 78 AB - OBJECTIVES To describe the epidemiology of childhood tuberculosis in Wales and to assess the standard of management of patients with tuberculosis. DESIGN Retrospective study of data retrieved from case notes and review of radiographs of all identified patients. SUBJECTS Forty eight cases of tuberculosis and 10 of tuberculosis chemoprophylaxis in children under 15 years of age, in Wales, between January 1986 and December 1992. MAIN OUTCOME MEASURES Management of childhood tuberculosis in Wales compared with the published recommendations of the Joint Tuberculosis Committee of the British Thoracic Society. RESULTS Documentation was poor in most of the 48 cases of tuberculosis and only 31 (65%) were formally notified. One third of patients were asymptomatic and were detected by contact tracing; only eight (17%) were culture positive. Only 20% of patients from ethnic minorities had previously been immunised with BCG. Management and chemotherapy varied widely. Few patients were managed jointly by paediatricians and chest doctors. Only 10% completed treatment with a recommended chemotherapy regimen. In 37% of patients treatment was inadequate, and in the remainder either the choice of drugs or the duration of treatment was inappropriate. No patient died, nor had any relapsed by June 1995. CONCLUSIONS Very few cases of childhood tuberculosis were managed according to the recommendations of the British Thoracic Society. One third of patients with childhood tuberculosis were not notified Most case of tuberculosis were in white children Two thirds of patients had pulmonary disease; only two had tuberculous meningitis and none died BCG immunisation status and tuberculin skin test results were poorly documented Very few patients were jointly managed by paediatricians and chest doctors Drug treatment was often inappropriate, either with respect to the choice of drugs or the duration of treatment