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Published online before print February 27, 2009
Eur Respir J 2009, doi:10.1183/09031936.00031808
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09031936.00031808v1
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ORIGINAL ARTICLE

An evaluation of the completeness of reporting of childhood tuberculosis

S.S.S. Teo 1, M. Alfaham 2, M.R. Evans 3, J.M. Watson 4, A. Riordan 5, P. Sonnenberg 6, J. Clark 7, A. Hayward 8, M. Sharland 9, J. Moore-Gillon 10, V. Novelli 11, D. Quinn 4, D. Shingadia 11, for the British Paediatric Surveillance Unit Childhood Tuberculosis study group

1 Centre for Child Health, University of London, London, E1 2AT, United Kingdom
2 Dept of Child Health, Llandough Hospital, Cardiff, CF14 4XW, United Kingdom
3 Communicable Disease Surveillance Centre, National Public Health Service for Wales, Cardiff, CF10 3NW, United Kingdom
4 Respiratory Diseases Dept, Health Protection Agency, Centre for Infections, London, NW9 5EQ, United Kingdom
5 Royal Liverpool Children's Hospital (Alder Hey), Liverpool, L12 2AP, United Kingdom
6 Centre for Sexual Health and HIV Research, University College London, London, WC1E 6BT, United Kingdom
7 Dept of Paediatrics, Newcastle General Hospital, Newcastle, NE4 6BE, United Kingdom
8 Centre for Infectious Disease Epidemiology, NW3 2PF, University College London, London, United Kingdom
9 Paediatric Infectious Diseases Unit, St George's Hospital, London, SW17 0QT, United Kingdom
10 Dept of Respiratory Medicine, St Bartholomew's Hospital and Royal London Hospital, London, E1 1BB, United Kingdom
11 Dept of Infectious Diseases, Great Ormond Street Hospital, London, WC1N 3JH, United Kingdom


  Abstract

The sensitivity of the Enhanced Tuberculosis Surveillance (ETS) scheme for monitoring tuberculosis in children is unknown.

We used the British Paediatric Surveillance Unit (BPSU) reporting scheme to conduct a prospective observational study of tuberculosis in children aged under 16 years in the UK. Reported cases were then matched with records from the ETS database.

A total of 320 cases were reported to the BPSU between January and December 2004. We estimated that there were 557 paediatric cases in England, Wales and Northern Ireland in 2004: 222 (40%) cases reported to both BPSU and ETS, 98 (18%) reported to BPSU but not ETS and 237 (42%) reported to ETS but not BPSU. Children under five years old were significantly less likely to be reported to ETS compared with older children (p<0.01).

There is substantial underreporting of childhood tuberculosis especially of children under 5 years old. ETS provides a representative picture of the demographics but may miss about 20% of cases. This should be taken into account when planning training and resource requirements for tuberculosis. Increased efforts are needed to ensure that all paediatric cases are reported to ETS.

Keywords:  Child, disease notification, medical record linkage, population surveillance, tuberculosis






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Copyright © 2009 by the European Respiratory Society.