The clinical and molecular diagnosis of childhood and adolescent pulmonary tuberculosis in referral centers
Rev. Soc. Bras. Med. Trop
; 53: e20200205, 2020. tab, graf
Artigo
em Inglês
| Sec. Est. Saúde SP, Coleciona SUS, LILACS
| ID: biblio-1136899
Biblioteca responsável:
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.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Contexto em Saúde:
Doenças Negligenciadas
Problema de saúde:
Doenças Negligenciadas
/
Tuberculose
Base de dados:
LILACS
/
Sec. Est. Saúde SP
/
Coleciona SUS
Assunto principal:
Escarro
/
Tuberculose Pulmonar
/
Mycobacterium tuberculosis
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Criança
/
Criança, pré-escolar
/
Humanos
/
Lactente
/
Recém-Nascido
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Rev. Soc. Bras. Med. Trop
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
Universidade Federal Fluminense/BR
/
Universidade Federal do Rio de Janeiro/BR