Abstract
Purpose and Introduction
The burden of Tuberculosis (TB) in South Africa is significant with recent reports showing an increase in the incidence of multi-drug resistant (MDR) TB. Little is known of the incidence and epidemiology, especially of MDR Tuberculous arthritis in children in the South African setting. The purpose of this study is to identify the number of TB cases identified with positive histology, culture and sensitivity.
Methods
A retrospective review of laboratory results of children under the age of 14 years with Tuberculous arthritis at a South African Hospital between January 2008 and December 2012 was performed. The data was extracted from the NHLS data base for all synovium, bone or joint fluid collected for TB culture, sensitivity and histology.
Results
Over a five year period positive cultures were found in ten patients. Of these ten patients five were sensitive and two were resistant to Isoniazid and Rifampicin using polymerase chain reaction (PCR) testing. Three had no sensitivity requested. Positive histology was found in nine of these patients consisting of chronic granulomata. The mean white cell count was 9 X ?10?∘9cells/l (Range 5–20), mean C reactive protein was 22 mg/l (Range 2–57) and mean erythrocyte sedimentation rate was 36 mm/hr (Range 8–70). Four of the ten patients had HIV testing – they were all negative.
Conclusions
This study shows good correlation between positive TB culture and histology. The high prevalence of MDR TB (20%) in these patients is of major concern with further alarm regarding the appropriate treatment of these patients if sensitivities are not routinely checked. Emphasis must be placed on requesting and following up sensitivity testing in these patients.
NO DISCLOSURES
