Management of paediatric tuberculosis in leading UK centres: unveiling consensus and discrepancies

Turkova, A., Welch, S. B., Paton, J. Y., Riordan, A., Williams, B., Patel, S. V., Clark, J. E., Bernatoniene, J., Doerholt, K., Child, F., Walters, S., Riddell, A., Shingadia, D., Liebeschuetz, S. and Kampmann, B. (2014) Management of paediatric tuberculosis in leading UK centres: unveiling consensus and discrepancies. International Journal of Tuberculosis and Lung Disease, 18 9: 1047-1056. doi:10.5588/ijtld.14.0094


Author Turkova, A.
Welch, S. B.
Paton, J. Y.
Riordan, A.
Williams, B.
Patel, S. V.
Clark, J. E.
Bernatoniene, J.
Doerholt, K.
Child, F.
Walters, S.
Riddell, A.
Shingadia, D.
Liebeschuetz, S.
Kampmann, B.
Title Management of paediatric tuberculosis in leading UK centres: unveiling consensus and discrepancies
Journal name International Journal of Tuberculosis and Lung Disease   Check publisher's open access policy
ISSN 1027-3719
1815-7920
Publication date 2014-09-01
Year available 2014
Sub-type Article (original research)
DOI 10.5588/ijtld.14.0094
Open Access Status Not yet assessed
Volume 18
Issue 9
Start page 1047
End page 1056
Total pages 10
Place of publication Paris, France
Publisher International Union against Tuberculosis and Lung Disease / Union Internationale contre la Tuberculose et les Maladies Respiratoires
Language eng
Formatted abstract
Setting: Large specialist paediatric TB clinics in the UK.

Objective: To evaluate clinical practice and compare with national and international guidelines.

Design: A survey based on an electronic questionnaire on the management of latent tuberculous infection (LTBI) and tuberculosis (TB) disease was conducted in 13 specialist paediatric TB clinics. The consensus and discrepancies were evaluated by descriptive analysis.

Results: Practice was reportedly different when choosing age limits for preventive treatment for TB contacts with initially negative tuberculin skin tests (TSTs), interpretation of TST results and use of interferon-gamma release assays (IGRAs) in the context of LTBI. In relation to management of children with TB disease, practices varied for duration of treatment of osteoarticular TB, monitoring for ethambutol ocular toxicity and use of pyridoxine. There was limited experience with multidrug-resistant TB (MDR-TB), and over half of the clinics monitored MDR-TB contacts without giving preventive treatment.

Conclusions: The survey showed heterogeneity in several aspects of clinical care for children with TB. Available paediatric TB guidelines differ substantially, explaining the wide variations in management of childhood TB. Prospective paediatric studies are urgently required to inform and standardise clinical practice, especially in the context of evolving drug resistance.
Keyword Children
Clinical practice
Guidelines
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID NIHR/SRF-2009-02-07
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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