More reliable method to diagnose TB in young children

University of Cape Town researchers have found a less invasive and more reliable method of confirming pulmonary tuberculosis in infants and young children, especially those who are HIV infected.

In adults and older children, sputum induction has been successfully used. But infants, who usually swallow their sputum instead of coughing it out, were in the past subjected to gastric lavage, a procedure involving the removal of sputum from the stomach via a suction tube.

The new procedure, designed by UCT researcher Dr Heather Zar, involves infants being nebulised with concentrated salt water, after fasting overnight.

This forces the infant to cough up phlegm which is in turn suctioned out of the mouth.

“It worked very well and we almost doubled the diagnoses in comparison to the gastric lavage method,” Zar said.

The new method also enabled Zar to diagnose pneumocystis carinii pneumonia (PCP); an under-diagnosed infection often fatal in young children, especially those who are HIV infected.

The study conducted in several Cape Town hospitals found that sputum induction could be successfully performed in 142 of 149 children.

The youngest child in whom sputum was successfully obtained was one month old.

The study found that sputum induction was a more sensitive method than gastric lavage for growing the bacteria, detecting almost twice the number of children with pulmonary TB.

Pulmonary TB was a common diagnosis among the group with a high HIV prevalence and acute respiratory infection.


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