A survey of tuberculosis services in the UK.

Abstract

To determine the provision of services for children with tuberculosis (TB) living in the UK. A postal questionnaire was sent to the most appropriate paediatrician and adult physician in every acute hospital trust in the UK. Information was sought on inpatient and outpatient services for children with TB and for children in contact with TB. Responses were received from 323 individuals in 199 of the 205 trusts approached. The median number of children with TB seen per year at each trust was 1.5 (range 0-30). Inpatients were nearly all admitted to paediatric wards (197 (99%) trusts). In 141 trusts (71%) they were looked after solely by paediatricians or jointly by paediatricians and physicians (47 trusts, 24%). 132 (66%) trusts stated there was a named consultant for children with TB. Negative pressure isolation rooms were reported to be available for children in 42 trusts (21%). As outpatients, children with TB were seen in paediatric clinics in 163 (82%) trusts. Only 10 (5%) trusts had designated family TB clinics. Children in contact with TB were managed by paediatricians in 81 (38%) trusts, by physicians in 67 (34%) trusts and jointly in 51 (26%) trusts. 161 (81%) trusts had access to a TB nurse and directly observed therapy (DOTS) was available in 116 (58%) trusts. Many paediatricians see few children with TB, but most children with TB are looked after by general paediatricians alone. The survey supports national recommendations to develop family clinics and clinical service networks for children with TB, which may improve the care of these children.