Tuberculosis of the spine in children at Muhimbili Medical Centre, Dar es Salaam.

A retrospective study of 22 children with tuberculosis of the spine who were managed at Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC), Dar es Salaam between 1988 and 1993 was done. There were 12 boys and 10 girls of ages ranging from 3-13 years. Majority of the patients presented with back pain and/or deformity and weakness in the legs associated with difficulty in walking. The diagnosis was based on radiological as well as haematological findings. Two patients had associated lung lesions and these gave AFB positive sputum. Majority (63.5%) were thoracolumbar T11-L2. All patients received chemotherapy and in addition two had simple drainage of paravertebral abscesses and two debridement and bone grafting. There was no formal immobilization except that they had to sleep on hard beds. All gave a history of BCG vaccination scars. Mantoux or Heaf test was done on 16/22, patients of whom 11/16 (68.8%) were positive. One patient ended up with paraplegia, one with marked paraparesis and in 17/22 the kyphosis/gibbus increased. Laxity in the tuberculosis control programmes and the widespread of HIV could play part in what seems to be a flare up of tuberculosis infection in the recent past.