Challenges in diagnosing tuberculosis in children: a comparative study from Sudan
Challenges in diagnosing tuberculosis in children: a comparative study from Sudan
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DOI：
10.1016/j.ijid.2015.12.006
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发表时间：
2016-02-01
影响因子：
8.4
通讯作者：
Hamid, Mohamed E.
中科院分区：
文献类型：
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作者：
Elhassan, Mogahid M.;Elmekki, Miskelyemen A.;Hamid, Mohamed E.
目的：由于标本材料不足和标本中细菌的稀少，儿童结核病(TB)的诊断具有挑战性。本研究旨在评价苏丹儿童结核病的诊断方法。方法：对197例儿童结核病患者进行结核菌素皮肤试验(TST)。结果：16.2%的标本在Lowenstein-Jensen培养液中生长。比较分析，TST法阳性率为43.7%(敏感度100%，特异度67.3%)，Ziehl-Neelsen染色阳性率为8.1%(敏感度43.8%，特异度98.8%)，金胺染色阳性率为11.2%(敏感度56.3%，特异度98.8%)，IS6110序列PCR扩增阳性率为17.8%(敏感度100%，特异度98.8%)。建议将TST用于常规诊断，并根据设备和紧急情况对特定病例使用聚合酶链式反应。(C)2015年提交人。爱思唯尔有限公司代表国际传染病学会出版。
Objectives: The diagnosis of tuberculosis (TB) in children is challenging due to insufficient specimen material and the scarcity of bacilli in specimens. This study aimed to evaluate methods for diagnosing TB in children in Sudan.Methods: Patients (N = 197) were subjected to the tuberculin skin test (TST). Gastric lavage or sputum specimens were then collected, processed, and cultured as per standard procedures.Results: Culture on Lowenstein-Jensen medium, the reference standard, revealed growth in 16.2% of the specimens. Comparative analysis showed that 43.7% were positive for the TST (sensitivity 100%, specificity 67.3%), 8.1% were positive by Ziehl-Neelsen stain (sensitivity 43.8%, specificity 98.8%), 11.2% by auramine stain (sensitivity 56.3%, specificity 98.8%), and 17.8% were positive for PCR amplification of the IS6110 sequence (sensitivity 100%, specificity 98.8%).Conclusions: It is concluded that whilst TST and IS6110 achieved 100% sensitivity based on the reference standard of culture, the latter was more specific. The TST is recommended for routine diagnosis and the use of PCR for particular cases, depending on the facilities and the urgency. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.