Incomplete Registration and Reporting of Culture-confirmed Childhood Tuberculosis Diagnosed in Hospital

Overview

Journal Public Health Action

Date 2015 Sep 23

PMID 26392930

Citations 30

Authors

K Du Preez

H S Schaaf

R Dunbar

A Swartz

K Bissell

D A Enarson

A C Hesseling

Affiliations

Soon will be listed here.

Abstract

Setting: The South African National Tuberculosis Programme (NTP) recommends the registration of tuberculosis (TB) patients at community clinics. TB in children is often diagnosed at referral hospitals, and there are concerns as to whether these children are accurately reflected in routine NTP reporting.

Objective: To assess the completeness of registration of children with culture-confirmed TB diagnosed in a referral hospital, in the routine provincial electronic TB register (ETR.Net), and to describe TB treatment outcomes.

Design: A retrospective cohort study including children aged <13 years diagnosed with culture-confirmed TB at Tygerberg Children's Hospital from July 2007 to June 2009. Data on demographic, clinical and referral factors were collated from hospital data sources. Electronic matching was used to identify children in the provincial ETR.Net.

Results: Only 166 of 267 (62%) children were registered in ETR.Net. Children with TB meningitis and death prior to referral were significantly less likely to be registered. Treatment outcome data were available for only 70% of children; favourable outcomes were reported in 56%.

Conclusions: A large proportion of children diagnosed with confirmed TB at a referral hospital were not registered, resulting in underreporting of the burden and severity of childhood TB. Routine surveillance of childhood TB should include linkage of hospital data.

Citing Articles

Global burden of tuberculous meningitis in children aged 0-14 years in 2019: a mathematical modelling study.

du Preez K, Jenkins H, Martinez L, Chiang S, Dlamini S, Dolynska M Lancet Glob Health. 2024; 13(1):e59-e68.

PMID: 39706662 PMC: 11729397. DOI: 10.1016/S2214-109X(24)00383-8.

Incomplete tuberculosis reporting and registration to the surveillance system in southwestern China of Yunnan Province: an inventory survey.

Chen J, Qiu Y, Wu W, Pan Y, Yang R, Li L BMC Public Health. 2024; 24(1):1397.

PMID: 38789991 PMC: 11127390. DOI: 10.1186/s12889-024-18794-2.

Reducing Initial Loss to Follow-up Among People With Bacteriologically Confirmed Tuberculosis: LINKEDin, a Quasi-experimental Study in South Africa.

Meehan S, Hesseling A, Boulle A, Chetty J, Connell L, Dlamini-Miti N Open Forum Infect Dis. 2024; 11(1):ofad648.

PMID: 38221986 PMC: 10787480. DOI: 10.1093/ofid/ofad648.

Under-Reporting of Tuberculosis Disease among Children and Adolescents in Low and Middle-Income Countries: A Systematic Review.

Linn A, Dubois M, Steenhoff A Trop Med Infect Dis. 2023; 8(6).

PMID: 37368718 PMC: 10304505. DOI: 10.3390/tropicalmed8060300.

UMOYA: a prospective longitudinal cohort study to evaluate novel diagnostic tools and to assess long-term impact on lung health in South African children with presumptive pulmonary TB-a study protocol.

Dewandel I, Van Niekerk M, Ghimenton-Walters E, Palmer M, Anthony M, McKenzie C BMC Pulm Med. 2023; 23(1):97.

PMID: 36949477 PMC: 10032249. DOI: 10.1186/s12890-023-02329-3.

References

Edginton M, Wong M, Hodkinson H . Tuberculosis at Chris Hani Baragwanath Hospital: an intervention to improve patient referrals to district clinics. Int J Tuberc Lung Dis. 2006; 10(9):1018-22. View

. Revised international definitions in tuberculosis control. Int J Tuberc Lung Dis. 2001; 5(3):213-5. View

DUNN H . Record Linkage. Am J Public Health Nations Health. 1946; 36(12):1412-6. PMC: 1624512. View

Botha E, Den Boon S, Lawrence K, Reuter H, Verver S, Lombard C . From suspect to patient: tuberculosis diagnosis and treatment initiation in health facilities in South Africa. Int J Tuberc Lung Dis. 2008; 12(8):936-41. View

Marais B, Gie R, Schaaf H, Hesseling A, Obihara C, Starke J . The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis. 2004; 8(4):392-402. View

Meray N, Reitsma J, Ravelli A, Bonsel G . Probabilistic record linkage is a valid and transparent tool to combine databases without a patient identification number. J Clin Epidemiol. 2007; 60(9):883-91. DOI: 10.1016/j.jclinepi.2006.11.021. View

Loveday M, Thomson L, Chopra M, Ndlela Z . A health systems assessment of the KwaZulu-Natal tuberculosis programme in the context of increasing drug resistance. Int J Tuberc Lung Dis. 2008; 12(9):1042-7. View

Marais B, Hesseling A, Gie R, Schaaf H, Beyers N . The burden of childhood tuberculosis and the accuracy of community-based surveillance data. Int J Tuberc Lung Dis. 2006; 10(3):259-63. View

Edginton M, Wong M, Phofa R, Mahlaba D, Hodkinson H . Tuberculosis at Chris Hani Baragwanath Hospital: numbers of patients diagnosed and outcomes of referrals to district clinics. Int J Tuberc Lung Dis. 2005; 9(4):398-402. View

10.

. Guidance for National Tuberculosis Programmes on the management of tuberculosis in children. Chapter 1: introduction and diagnosis of tuberculosis in children. Int J Tuberc Lung Dis. 2006; 10(10):1091-7. View

11.

Dunbar R, Lawrence K, Verver S, Enarson D, Lombard C, Hargrove J . Accuracy and completeness of recording of confirmed tuberculosis in two South African communities. Int J Tuberc Lung Dis. 2011; 15(3):337-43. View

12.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007; 370(9596):1453-7. DOI: 10.1016/S0140-6736(07)61602-X. View

13.

Fair M, Cyr M, Allen A, Wen S, Guyon G, Macdonald R . An assessment of the validity of a computer system for probabilistic record linkage of birth and infant death records in Canada. The Fetal and Infant Health Study Group. Chronic Dis Can. 2000; 21(1):8-13. View