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. 2022 Mar 23:41:241.
doi: 10.11604/pamj.2022.41.241.31928. eCollection 2022.

Loss to long-term follow-up in children with spinal tuberculosis: a retrospective cohort study at a tertiary hospital in the Western Cape, South Africa

Theresa Naomi Mann  1   2 , Sanesh Miseer  1 , Hendrik Simon Schaaf  3 , Robin Dyers  4   5 , Johan Hendrik Davis  1   2
Affiliations

Loss to long-term follow-up in children with spinal tuberculosis: a retrospective cohort study at a tertiary hospital in the Western Cape, South Africa

Theresa Naomi Mann et al. Pan Afr Med J. .

Abstract

Introduction: children with spinal tuberculosis (TB) are at risk of kyphotic deformity both during and after the active phase of the disease. Management guidelines include follow-up until skeletal maturity. Little is known about adherence to this recommendation. This study aimed to investigate loss to long-term spine clinic follow-up (LTFU) among children with spinal TB at a tertiary hospital in the Western Cape Province, South Africa.

Methods: this retrospective cohort study included all children diagnosed with spinal TB at Tygerberg Hospital between January 2012 and December 2015. Spine clinic follow-up was investigated for five years following diagnosis. Relevant surgical interventions and re-presentation were evaluated until 31st December 2020.

Results: thirty-two children, median age 6 years (range 1-14 years), were diagnosed with spinal TB and intended for spine clinic follow-up. Twenty-seven (84%) children were LTFU within five years of diagnosis with 16 (50%) LTFU within 10.5 months. Among children in follow-up, one child had further surgery for progression of deformity two years from diagnosis and one child had further surgery for new-onset neurological deficit eight years from diagnosis.

Conclusion: most children with spinal TB did not receive the recommended follow-up until skeletal maturity. Without further data on these children, the clinical significance of this LTFU could not be evaluated. Further studies are needed to investigate sequelae during skeletal maturation in the context of current management for paediatric spinal TB.

Keywords: Tuberculosis; child; follow-up studies; kyphosis; spinal.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan Meier survival curve of children with spinal tuberculosis in spine clinic follow-up
Figure 2
Figure 2
comparison of Kaplan Meier survival curves for children with spinal tuberculosis in spine clinic follow-up, grouped according to (A) age, (B) sex, (C) health district, (D) spine-at-risk signs, (E) surgery and (F) discharge pathway; *significant difference between curves at p ≤ 0.05
See this image and copyright information in PMC

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