G589(P) Childhood tuberculosis still a significant burden: experience of a district dedicated tuberculosis service

<h3>Aims</h3> Evaluate our experience of a dedicated Tuberculosis service for children in a district general setting. <h3>Methods</h3> Rates of Tuberculosis (TB) in our area in the South East are the second highest in England and our Trust covers areas of significant deprivation. There became a need to set up a dedicated service for childhood TB in partnership with our TB community nursing team and close liaison with adult respiratory colleagues. We started in 2005 to run a monthly clinic with 2 consultants with training in TB and a dedicated TB Nurse a unique service in the South.We analysed retrospectively our recent experience 2017 to 2018. <h3>Results</h3> 10 cases of active TB were identified,age range 11 weeks to 16 years, 6 Caucasian, 2 Nepalese and 2 Eritrean. There were 37 cases latentTB age range 1 month to 16 years, 14 Caucasian, 15 Nepalese and 8 Indian. The active cases all had pulmonary TB with 100% cough, 50% haemoptysis,30% fever,20% night sweats,20% weight loss. History of contact with smear positive adult in 70% and foreign travel 40%. Chest X Ray changes 70%: 2 RUL, 3 RLL, Pleural effusion,1 hilar nodes. ESR raised 40%,Mantoux positive 90%,T Spot positive 70%, AAFBs or culture TB 20%. All HIV negative. All successfully treated using DOT and VOTs. Use of Latent TB government video for explaining latent TB was popular. All cases were discussed with Adult TB team and clinic visits always had TB nurse present. <h3>Conclusions</h3> In areas with high rates of TB in a district a dedicated district service seems an effective way to see patients within a Mutidiscliplinary Team and allows good liason with Adult TB team. The setting up of networks for Paediatric TB may encourage this set up with discussion of active cases with tertiary infectious disease specialists while maintaining good local supportive supervision and deliver of care.