Paediatric admissions to a TB hospital: reasons for admission, clinical profile and outcomes

Abstract

<b>BACKGROUND:</b> Brooklyn Chest Hospital (BCH) is a specialised TB hospital in Cape Town, South Africa. We describe reasons for admission, patient profiles and hospital-discharge outcomes in children admitted to BCH. This was compared to a previous study (2000-2001).<b>METHODS:</b> This retrospective, descriptive study included all children (0-14 years) admitted to BCH from January 2016 to December 2017. Data collected from patient folders and a laboratory database included demographic data, reasons for admission, clinical data and hospital outcomes.<b>RESULTS:</b> Of 263 children admitted, 133 (50.6%) were male. The median age was 32 months (IQR 15-75); 48 (18.3%) were HIV-positive and 150 (57.0%) had bacteriologically confirmed TB. Reasons for admission included social/caregiver-related (<i>n</i> = 119, 45.2%), drug-resistant TB (<i>n</i> = 114, 43.3%), TB meningitis (<i>n</i> = 86, 32.7%) and other severe types of TB (<i>n</i> = 63, 24.0%); 110 (41.8%) children had >1 reason for admission. TB meningitis admissions decreased (<i>P</i> = 0.014) and those for drug-resistant TB increased (<i>P</i> < 0.001) compared to 2000-2001. Pulmonary TB was diagnosed in 234 (89.0%), extrapulmonary TB in 149 (56.7%) and 126 (47.9%) had both. At discharge, 73 (27.8%) had completed treatment, 182 (69.2%) were transferred out to complete treatment at community clinics, and 6 (2.3%) died.<b>CONCLUSIONS:</b> Although most children were admitted for clinical reasons, social/caregiver-related reasons were also important.