Impact of the introduction of a paediatric ‘virtual TB clinic’

Introduction: We present the results of a paediatric virtual TB clinic established to improve patient diagnosis and treatment across a large geographical area. The clinic runs weekly using teleconferencing supported by clinical documentation and electronic image sharing to provide tertiary support to local district hospitals. Method: All patients discussed at the virtual TB clinic from November 2017 to November 2018 were included. We assessed the impact on patients with respect to changes in; diagnosis, radiology interpretation, investigation, treatment, follow up and location of care. Results: In the first year, there were 65 discussions about 42 children in the virtual clinic from 8 district hospitals. 16 children had TB disease, 13 LTBI and 13 no evidence of TB infection. Referrers sought advice on radiology 22 (55%), investigation options 22(55%) and screening 15 (36%). 16 (38%) discussions led to a change of management. In 5 of these children (31%) there was a change of diagnosis. Importantly two children were treated for active disease that had previously been diagnosed as latent TB, one of whom was aged Conclusion: The TB virtual clinic has been well received by TB teams across the region and the number of patients discussed continues to increase. This approach has been shown to improve diagnosis and management of Paediatric TB patients. It provides a mechanism to support unplanned gaps in workforce, ensure consistency of school screening events, prevent referral to tertiary care and facilitate earlier return to local care.