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The clinical and molecular diagnosis of childhood and adolescent pulmonary tuberculosis in referral centers
Aurilio, Rafaela Baroni; Luiz, Ronir Raggio; Land, Marcelo Gerardin Poirot; Cardoso, Claudete Aparecida Araújo; Kritski, Afrânio Lineu; SantAnna, Clemax Couto.
Affiliation
  • Aurilio, Rafaela Baroni; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Pediatria. Rio de Janeiro. BR
  • Luiz, Ronir Raggio; Universidade Federal do Rio de Janeiro. Instituto de Estudos de Saúde Coletiva. Rio de Janeiro. BR
  • Land, Marcelo Gerardin Poirot; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Pediatria. Rio de Janeiro. BR
  • Cardoso, Claudete Aparecida Araújo; Universidade Federal Fluminense. Faculdade de Medicina. Departamento de Saúde Materno Infantil. Niterói. BR
  • Kritski, Afrânio Lineu; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Programa Acadêmico de Tuberculose da Faculdade de Medicina. Rio de Janeiro. BR
  • SantAnna, Clemax Couto; Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Pediatria. Rio de Janeiro. BR
Rev. Soc. Bras. Med. Trop ; 53: e20200205, 2020. tab, graf
Article in En | SES-SP, ColecionaSUS, LILACS | ID: biblio-1136899
Responsible library: BR1.1
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.
Subject(s)
Key words

Full text: 1 Index: LILACS Main subject: Sputum / Tuberculosis, Pulmonary / Mycobacterium tuberculosis Type of study: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Newborn Country/Region as subject: America do sul / Brasil Language: En Journal: Rev. Soc. Bras. Med. Trop Journal subject: MEDICINA TROPICAL Year: 2020 Type: Article

Full text: 1 Index: LILACS Main subject: Sputum / Tuberculosis, Pulmonary / Mycobacterium tuberculosis Type of study: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Newborn Country/Region as subject: America do sul / Brasil Language: En Journal: Rev. Soc. Bras. Med. Trop Journal subject: MEDICINA TROPICAL Year: 2020 Type: Article