[Analysis of the diagnostic criteria used in childhood tuberculosis in a Cote d'Ivoire hospital].
Based on a retrospective study the authors analyzed the diagnostic criteria used in pediatric department in Yopougon CHU (teaching hospital), from January 1996 to December 2002. Fifty children, aged of 1 month to 15 years, have been studied. The tuberculosis contact was found in 18%. The diagnosis of tuberculosis was accurate in 32% and it was based on presumptive arguments in 68%. The pulmonary examination and pulmonary radiographs seem to be good criteria for the tuberculosis diagnosis. The pulmonary examination found an abnormality in 96%, and the radiographs found a pathological picture in 85% of cases. The skin test was positive in 42%. The Ziehl-Neelsen coloration was used to look for the acid-fast bacilli and it was positive in 41%. But the two last examinations were not reliable in the case of HIV infection. The skin test which is very important for the diagnosis of tuberculosis is often negative among HIV infected children because of their anergy. On the other hand, the Ziehl-Neelsen coloration is based on the recognition of the acid-fast bacillus, which is not specific of the Mycobacterium tuberculosis. In our area the prevalence of HIV/AIDS is high, the atypical pneumonia with Mycobacterium were also frequent and may reveal a wrong positive diagnosis for the tuberculosis diagnosis, as they are also acid-fast bacillus.
Adonis-Koffy
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Service de pédiatrie du CHU de Yopougon, 01 BP 240, Abidjan 01, Côte d'Ivoire. koflau@hotmail.com
Kouassi
F
F
Timité-Konan
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AM
D001431:Bacteriological Techniques / Q000592:standards / Q000706:statistics & numerical data; D001706:Biopsy / Q000592:standards / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing / Q000706:statistics & numerical data; D007560:Cote d'Ivoire / Q000453:epidemiology; D003906:Developing Countries; D005188:False Negative Reactions; D005189:False Positive Reactions; D005750:Gastric Juice / Q000382:microbiology; D015528:HIV Seroprevalence; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000592:standards / Q000706:statistics & numerical data; D013902:Radiography, Thoracic / Q000592:standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology; D014374:Tuberculin Test / Q000592:standards / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D014463:Ultrasonography / Q000592:standards / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data