Table 1.
Demographics, investigation of spine lesions and case classification of children and adults with spinal tuberculosis at tertiary hospitals in the Western Cape, 2012–2015
| Children (0–14 years) n = 74 (%) |
Adults (>14 years) n = 319 (%) |
All n = 393 (%) |
|
|---|---|---|---|
| Demographics | |||
| Age (median [IQR]) | 7 [4–11] | 38 [30–50] | 34 [23–47] |
| Gender (males) | 31 (42) | 137 (43) | 168 (43) |
| HIV status | |||
| Positive | 2 (3) | 132 (41) | 134 (34) |
| Negative | 51 (69) | 149 (47) | 200 (51) |
| Unknown | 21 (28) | 38 (12) | 59 (15) |
| Spine imaging | |||
| MRI/CT findingsa | n = 65 (88) | n = 317 (99) | 382 (97) |
| Suggestive of TB | 62 (95) | 309 (97) | 371 (97) |
| Not suggestive of TBb | 3 (5) | 8 (3) | 11 (3) |
| Spine biopsy pathology | |||
| Histology | n = 41 (55) | n = 272 (85) | n = 313 (80) |
| Necrotizing granulomatous inflammation | 31 (76) | 126 (46) | 157 (50) |
| Inconclusive | 10 (24) | 146 (54) | 156 (50) |
| Ziehl Neelsen stain | n = 40 (54) | n = 251 (79) | n = 291 (74) |
| Positive | 13 (33) | 36 (14) | 49 (17) |
| Negative | 27 (67) | 215 (86) | 242 (83) |
| Spine biopsy microbiology | |||
| Auramine stain | n = 51 (69) | n = 243 (76) | 294 (75) |
| Positive | 11 (22) | 55 (23) | 66 (22) |
| Negative | 40 (78) | 188 (77) | 228 (78) |
| Xpert MTB/RIF | n = 31 (42) | n = 180 (56) | n = 211 (54) |
| Positive | 24 (77) | 121 (67) | 145 (69) |
| Negative | 7 (23) | 59 (33) | 66 (31) |
| M. tuberculosis culture | n = 56 (76) | n = 298 (93) | n = 354 (90) |
| Positive | 35 (63) | 194 (65) | 229 (65) |
| Negative | 21 (37) | 104 (35) | 125 (35) |
| Case classification | |||
| Bacteriologically confirmed | 49 (66) | 234 (73) | 283 (72) |
| Clinically diagnosedc | 25 (34) | 85 (27) | 110 (28) |
Data are presented as n (%) for non-missing data, unless otherwise indicated, with % values rounded to the nearest whole number.
MRI, magnetic resonance imaging (n = 378); CT, computed tomography (n = 4).
Although MRI findings did not suggest TB, spinal TB was diagnosed following bacteriological (n = 10) or histological (n = 1) spine biopsy findings.
Among the clinically diagnosed cases (no bacteriological confirmation from a spine biopsy), seven adults and seven children had bacteriological confirmation from another site (lungs, n = 8; lymph node, n = 2; pleura, n = 1; knee, n = 1; groin, n = 1; liver, n = 1).