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Document Abstract
Published: 2011

Sputum induction for microbiological diagnosis of childhood pulmonary tuberculosis in a community setting

Sputum induction in primary health care facilities: increasing diagnosis and treatment of pulmonary tuberculosis in children
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Sputum induction has increasingly enabled microbiological confirmation of pulmonary tuberculosis (PTB) in hospitalised children, but it has not been evaluated in a community setting. This paper aims to investigate the yield, feasibility and safety of sputum induction for the diagnosis of TB in children in a primary health care facility.

Conducting their research in South Africa, the authors present these findings:

  • sputum induction is highly successful procedure, and the yield from sputum induction is similar to that reported for adults, improves diagnostic yield and impacts on treatment 
  • operational and logistic issues may hamper the implementation of sputum induction in primary care facilities for children 
  • the main obstacles can be time constraints, lack of skill, space constraints and concerns about transmission 
  • the procedure has been rated easy or very easy to perform in more than 90% of cases after a short training period.

Conclusions are that:

  • sputum induction is feasible and safe in a community setting
  • sputum induction is useful for making a microbiological diagnosis, increasing the number of children diagnosed and treated for PTB
  • more widespread implementation of sputum induction for the diagnosis of PTB in children should be undertaken in primary care settings 
  • it should be noted that timely transfer of specimens to a laboratory or on-site testing is needed 
  • future development of rapid molecular-based testing that can be performed onsite is promising and may boost diagnosing PTB in low care setting.
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Authors

H.A. Moore; P. Apolles; H. J. Zar

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