Please use this identifier to cite or link to this item:
https://repositorio.inpa.gov.br/handle/1/18005
Title: | Evaluation of new strategies for the diagnosis of tuberculosis among pediatric contacts of tuberculosis patients |
Authors: | Perez-Porcuna, T. M. Ascaso Terrén, Carlos Ogusku, Maurício Morishi Abellana, R. Malheiro, Adriana Quincó, Patrícia Antunes, Irineide Assumpção Monte, Rossicléia Lins Tavares, Michel Garrido, Marlúcia Silva Bührer-Sékula, Samira Martínez-Espinosa, Flor Ernestina |
Keywords: | Bcg Vaccine Bacterium Culture Bcg Vaccination Chemoprophylaxis Child Clinical Classification Clinical Protocol Controlled Study Diagnostic Test Early Diagnosis Female Human Infant Laboratory Diagnosis Liquid Culture Lung Tuberculosis Major Clinical Study Male Mycobacteria Growth Indicator Tube Mycobacterium Tuberculosis Nasopharyngeal Aspiration Nutritional Status Outpatient Care Polymerase Chain Reaction Child, Preschool Priority Journal Scoring System Sensitivity And Specificity Sputum Analysis Sputum Smear Thorax Radiography Tuberculin Test Chi-square Distribution Child, Preschool Contact Tracing Female Humans Infant Male Roc Curve Sputum Tuberculin Test Tuberculosis |
Issue Date: | 2012 |
metadata.dc.publisher.journal: | Pediatric Infectious Disease Journal |
metadata.dc.relation.ispartof: | Volume 31, Número 9, Pags. e141-e146 |
Abstract: | Background: In young children, underdiagnosis and diagnostic delay have an adverse effect on morbidity and mortality of tuberculosis (TB). This study evaluated new strategies for early TB diagnosis using an outpatient protocol in children between 0 and 5 years of age, with a recent household TB contact. Methods: Case recruitment was performed in Manaus, Amazonas, Brazil, from 2008 to 2009. Epidemiologic and clinical data, tuberculin test, chest radiograph and 2 induced sputum respiratory samples from each participant were obtained. Laboratory diagnosis was based on Lowenstein-Jensen (LJ) culture, mycobacteria growth indicator tube (MGIT) and polymerase chain reaction. We conducted a study of comparison of diagnostic tests and a study of cases and controls to identify the clinical characteristics of the population with positive culture and polymerase chain reaction results. Results: A total of 102 children were evaluated. Thirty-two fulfilled criteria of suspicion of TB. MGIT was more sensitive (P = 0.035) and faster (P < 0.001) than LJ. Clinical score, MGIT, LJ and polymerase chain reaction presented no concordance or slight concordance. A positive MGIT culture was only associated with a strong tuberculin test reaction (P = 0.026). The combination of MGIT with the clinical score allowed the diagnosis of 33% more cases with little or no symptomatology compared with the exclusive use of the clinical classification. Conclusions: The sensitivity and speed of MGIT demonstrate the utility of liquid cultures for the diagnosis in children. Furthermore, these results suggest that the use of MGIT in children presenting recent household TB contact and a strong tuberculin test reaction may be a strategy to improve early TB diagnosis. © 2012 by Lippincott Williams and Wilkins. |
metadata.dc.identifier.doi: | 10.1097/INF.0b013e31825cbb3b |
Appears in Collections: | Artigos |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.