[Evaluation of a scoring system recommended by the Brazilian Ministry of Health for the diagnosis of childhood tuberculosis].
Tuberculosis is currently one of the main causes of death in the world. One of the difficulties for tuberculosis diagnosis in childhood is the bacteriological identification of Mycobacterium tuberculosis. This nested case-control study aimed to compare the diagnostic values of a scoring system proposed by the Brazilian Ministry of Heath for diagnosis of childhood tuberculosis using gastric washing samples taken in the outpatient and hospital settings. A total of 108 children underwent gastric washing (53 with and 55 without tuberculosis). The scoring system proposed by the Brazilian Ministry of Heath for diagnosis of tuberculosis in children with negative sputum smears showed good sensitivity in both groups, and the best cutoff point was "1" (possible tuberculosis), with 92% sensitivity, thus feasible for use as an ancillary diagnostic test in children submitted to gastric washing. Our recommendation is that the Ministry of Health scoring system be used by health services to assist the physician in deciding on whether to continue the investigation of childhood tuberculosis, and not only in children who have already undergone the procedure and who have shown negative results.
Maciel
Ethel Leonor Noia
EL
Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brasil. emaciel@ndi.ufes.br
Dietze
Reynaldo
R
Silva
Rita Elizabeth Checon de Freitas
RE
Hadad
David Jamil
DJ
Struchiner
Claudio Jose
CJ
D000293:Adolescent; D001938:Brazil; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D005751:Gastric Lavage; D006077:Government Agencies; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009752:Nutritional Status; D011859:Radiography; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging