Microscopic observation drug susceptibility assay (MODS) for early diagnosis of tuberculosis in children.
MODS is a novel liquid culture based technique that has been shown to be effective and rapid for early diagnosis of tuberculosis (TB). We evaluated the MODS assay for diagnosis of TB in children in Viet Nam. 217 consecutive samples including sputum (n = 132), gastric fluid (n = 50), CSF (n = 32) and pleural fluid (n = 3) collected from 96 children with suspected TB, were tested by smear, MODS and MGIT. When test results were aggregated by patient, the sensitivity and specificity of smear, MGIT and MODS against "clinical diagnosis" (confirmed and probable groups) as the gold standard were 28.2% and 100%, 42.3% and 100%, 39.7% and 94.4%, respectively. The sensitivity of MGIT and MODS was not significantly different in this analysis (P = 0.5), but MGIT was more sensitive than MODS when analysed on the sample level using a marginal model (P = 0.03). The median time to detection of MODS and MGIT were 8 days and 13 days, respectively, and the time to detection was significantly shorter for MODS in samples where both tests were positive (P<0.001). An analysis of time-dependent sensitivity showed that the detection rates were significantly higher for MODS than for MGIT by day 7 or day 14 (P<0.001 and P = 0.04), respectively. MODS is a rapid and sensitive alternative method for the isolation of M.tuberculosis from children.
Ha
Dang Thi Minh
DT
TB Department, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. hadtm@oucru.org
Lan
Nguyen Thi Ngoc
NT
Wolbers
Marcel
M
Duong
Tran Ngoc
TN
Quang
Nguyen Dang
ND
Thi Van Thinh
Tran
T
Thi Hong Ngoc
Le
L
Thi Ngoc Anh
Nguyen
N
Van Quyet
Tran
T
Thi Bich Tuyen
Nguyen
N
Thi Ha
Vo
V
Day
Jeremy
J
Thi Thanh Hang
Hoang
H
Kiet
Vo Sy
VS
Thi Nho
Nguyen
N
Hoa
Dai Viet
DV
Dung
Nguyen Huy
NH
Huu Lan
Nguyen
N
Farrar
Jeremy
J
Caws
Maxine
M
D000293:Adolescent; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D003710:Demography; D003955:Diagnostic Tests, Routine / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000302:isolation & purification; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000628:therapy