Complementary surveillance strategies are needed to better characterise the epidemiology, care pathways and treatment outcomes of tuberculosis in children

Table 2 Care pathways and treatment outcomes^a of children with tuberculosis managed at Tygerberg Hospital during 2012

TB diagnosis pathways in relation to Tygerberg Hospital (TBH) presentation	n = 395 (%)
TB diagnosis made during/following current presentation to TBH	304 (77.0)
TB diagnosis made prior to TBH admission	91 (23.0)
Duration of TB treatment at time of TBH admission (n = 91)
0–14 days on TB treatment	41 (45.1)
15–60 days on TB treatment	23 (25.3)
> 60 days on TB treatment	27 (29.7)
Level of care at which TB diagnosis was made (n = 91)
Diagnosed at hospital level	76 (83.5)
Diagnosed at a community primary health care (PHC) facility	15 (16.5)
Discharge referral pathways to continue TB care^b
Community-based TB services (PHC facilities)	244/386 (63.2)
Hospital-based outpatient follow–up at TBH	28/386 (7.3)
TB hospitals	82/386 (21.2)
Other^c	32/386 (8.3)
TB treatment outcomes for children treated as drug-susceptible TB^d	n = 344 (%)
Favourable treatment outcomes (Total)	300 (87.2)
Cured	12 (3.5)
Treatment completed	288 (83.7)
Unfavourable treatment outcomes (Total)	44 (12.8)
Died^d	17 (4.9)
Lost to-follow up^e	23 (6.7)
Treatment failure	1 (0.3)
Transferred out	3 (0.9)
TB treatment outcomes for children treated as drug-resistant TB^f	n = 51 (%)
Favourable treatment outcomes (Total)	50 (98.0)
Cured	14 (27.5)
Treatment completed	36 (70.6)
Unfavourable treatment outcomes (Total)	1 (2.0)
Died	0
Lost to-follow up	1 (2.0)
Treatment failure	0
Transferred out	0

^aOutcome information was firstly collected through probabilistic record linkage with electronic TB treatment registers. If information was not found in the registers, additional follow up information on outcomes were obtained from repeated reviews of medical records, telephonic contact with the facilities patients were discharged to (TB hospitals and community PHC facilities), as well as the National Health Laboratory Service database
^bExcludes children who died during hospital admission (n = 9)
^cIncludes referrals to secondary hospitals (n = 23), chronic medium term care facilities (n = 8) and one child that completed TB treatment during a non-TB related admission
^dIncludes two children that died during hospital admission before TB treatment was initiated, but subsequently had a positive culture for drug-susceptible TB
^eIncludes 10 children (2.9%) for whom no follow up documentation could be found in any available data sources
^fIncludes 9 children with isoniazid mono-resistant TB, 4 with rifampicin mono-resistant TB, 34 with multidrug-resistant TB, and 4 with extensively drug-resistant TB
TB Tuberculosis, TBH Tygerberg Hospital, PHC Primary healthcare

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