The clinical and molecular diagnosis of childhood and adolescent pulmonary tuberculosis in referral centers
Rev. Soc. Bras. Med. Trop
;
53: e20200205, 2020. tab, graf
Article
Dans Anglais
| SES-SP, ColecionaSUS, LILACS
| ID: biblio-1136899
ABSTRACT
Abstract INTRODUCTION:
The diagnostic accuracy of Xpert MTB/RIF (Xpert) in pulmonary tuberculosis (PTB) in children is lower than in adults. In Brazil, the diagnosis of PTB is based on a diagnostic score system (DSS). This study aims to study the role of Xpert in children and adolescents with PTB symptoms.METHODS:
A cross-sectional study was conducted in 3 referral centers to TB. Children and adolescents (0-19 years old) whose respiratory samples were submitted to Xpert were included. Statistical analysis (bivariate and logistic regression) to assess the simultaneous influence of TB-related variables on the occurrence of Xpert detectable in TB cases was done. To evaluate the agreement or disagreement between Xpert results with acid-fast bacillus (AFB) and cultures, κ method was used (significancy level of 5%).RESULTS:
Eighty-eight patients were included in the study and PTB occurred in 43 patients (49%) and Xpert was detectable in 21 patients (24%). Adolescents and positive culture results were independent predictive variables of Xpert positivity. DSS sensitivity compared with the final diagnosis of TB was 100% (95% CI, 88.1-100%), specificity was 97.2% (95% CI, 85.5-99.9%). The accuracy of the method was 98.5% (95% CI, 91.7-99.9%).CONCLUSIONS:
Xpert contributed to diagnosis in 9% of patients with AFB and in culture negative cases. DSS indicated relevance for this diagnostic approach of intrathoracic TB (ITB) in reference centers for presenting data both with high sensitivity and specificity.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Expectoration
/
Tuberculose pulmonaire
/
Mycobacterium tuberculosis
Type d'étude:
Etude diagnostique
/
Étude observationnelle
/
Étude de prévalence
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adolescent
/
Adulte
/
Enfant
/
Enfant d'âge préscolaire
/
Humains
/
Bébé
/
Nouveau-né
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Rev. Soc. Bras. Med. Trop
Année:
2020
Type:
Article
Institution/Pays d'affiliation:
Universidade Federal Fluminense/BR
/
Universidade Federal do Rio de Janeiro/BR
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