Incomplete registration and reporting of culture-confirmed childhood tuberculosis diagnosed in hospital.

Abstract

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. 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. 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. 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%. 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.