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

Int J Tuberc Lung Dis. 2011 Sep;15(9):1185-90, i. doi: 10.5588/ijtld.10.0681.


Setting: Sputum induction has increasingly enabled microbiological confirmation of pulmonary tuberculosis (PTB) in hospitalised children, but it has not been evaluated in a community setting.

Objective: To investigate the yield, feasibility and safety of sputum induction for the diagnosis of TB in children in a primary health care facility.

Design: A prospective study in a primary health care clinic in South Africa from April 2007 to June 2009. Consecutive children with clinically suspected PTB, with a household adult PTB contact or human immunodeficiency virus infected with respiratory symptoms were enrolled. History, clinical examination, tuberculin skin test and chest X-ray results were recorded. Two sequential induced sputum specimens were obtained for smear and culture.

Results: A total of 270 children were enrolled (median age 38 months); sputum induction was successful in 269 (99%); 65 (24%) children were clinically diagnosed, of whom 11 (16.9%) were microbiologically confirmed. An additional 18 children not clinically diagnosed had microbiological confirmation of PTB and were placed on TB treatment thereafter, increasing the diagnostic yield by 21.6%, from 65 to 83 cases. Sputum induction procedures were well tolerated; no major adverse events occurred.

Conclusion: Sputum induction is feasible and safe in a community setting. Sputum induction was useful for making a microbiological diagnosis, increasing the number of children diagnosed and treated for PTB.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Male
  • Primary Health Care / methods*
  • Prospective Studies
  • South Africa
  • Sputum / metabolism
  • Sputum / microbiology*
  • Tuberculosis, Pulmonary / diagnosis*