title: Microscopic observation drug susceptibility assay (MODS) for early diagnosis of tuberculosis in children.
abstract: 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.
authors.affiliation: TB Department, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. hadtm@oucru.org
authors.forename: Dang Thi Minh
authors.initials: DT
authors.lastname: Ha
authors.forename: Nguyen Thi Ngoc
authors.initials: NT
authors.lastname: Lan
authors.forename: Marcel
authors.initials: M
authors.lastname: Wolbers
authors.forename: Tran Ngoc
authors.initials: TN
authors.lastname: Duong
authors.forename: Nguyen Dang
authors.initials: ND
authors.lastname: Quang
authors.forename: Tran
authors.initials: T
authors.lastname: Thi Van Thinh
authors.forename: Le
authors.initials: L
authors.lastname: Thi Hong Ngoc
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Ngoc Anh
authors.forename: Tran
authors.initials: T
authors.lastname: Van Quyet
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Bich Tuyen
authors.forename: Vo
authors.initials: V
authors.lastname: Thi Ha
authors.forename: Jeremy
authors.initials: J
authors.lastname: Day
authors.forename: Hoang
authors.initials: H
authors.lastname: Thi Thanh Hang
authors.forename: Vo Sy
authors.initials: VS
authors.lastname: Kiet
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Nho
authors.forename: Dai Viet
authors.initials: DV
authors.lastname: Hoa
authors.forename: Nguyen Huy
authors.initials: NH
authors.lastname: Dung
authors.forename: Nguyen
authors.initials: N
authors.lastname: Huu Lan
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.forename: Maxine
authors.initials: M
authors.lastname: Caws
mesh_terms: 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