title: Scoring system for the diagnosis of tuberculosis in indigenous children and adolescents under 15 years of age in the state of Mato Grosso do Sul, Brazil.
abstract: OBJECTIVE
  To evaluate the process of diagnosing pulmonary tuberculosis in smear-negative indigenous children and adolescents under 15 years of age with the modified Brazilian National Ministry of Health Scoring System (mBNMH-SS).
  
  
  METHODS
  This was a retrospective descriptive study involving 49 indigenous patients under 15 years of age with tuberculosis, treated between 2007 and 2010 in the state of Mato Grosso do Sul, Brazil.
  
  
  RESULTS
  Of the 49 patients, 27 (56%) were under 5 years of age, 33 (67%) had symptoms suggestive of tuberculosis, 24 (49%) were underweight, and 36 (73.5%) had been BCG vaccinated. The tuberculin skin test was positive in 28 patients (57%), 18 (64%) of whom had an induration > 10 mm. Chest X-rays were performed in 37 (76%) of the patients, 31 (84%) of whom had only one chest X-ray taken. Among those 37 patients, the radiological findings were suggestive of tuberculosis in 16 (43%), infiltration/condensation in 10 (27%), and normal in 4 (11%). The Indigenous Health Care Teams made the diagnosis in 31 (63%) of the cases, using the original BNMH-SS in only 14 (45%). We calculated the mBNMH-SS scores for 30 (61%) of the 49 patients. Among the 30 cases scored, a diagnosis of tuberculosis was found to be highly likely, possible, and unlikely in 16 (53%), 11 (37%), and 3 (10%), respectively.
  
  
  CONCLUSIONS
  The proportion of highly likely and possible diagnoses was consistent with the standard proportion of cases diagnosed by the teams (90%), demonstrating the epidemiological applicability of the mBNMH-SS for the diagnosis of pulmonary tuberculosis in the indigenous population, within the scenario of the health care provided.
authors.affiliation: Anhanguera-Uniderp University, Campo Grande, Brazil. sandrachristo0@gmail.com
authors.forename: Sandra Christo dos
authors.initials: SC
authors.lastname: Santos
authors.forename: Ana Maria Campos
authors.initials: AM
authors.lastname: Marques
authors.forename: Roselene Lopes de
authors.initials: RL
authors.lastname: Oliveira
authors.forename: Rivaldo Venâncio da
authors.initials: RV
authors.lastname: Cunha
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003948:Diagnostic Techniques, Respiratory System / Q000592:standards; D005260:Female; D006077:Government Agencies; D006801:Humans; D007199:Indians, South American; D008297:Male; D009752:Nutritional Status / Q000502:physiology; D012189:Retrospective Studies; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000208:ethnology / Q000635:transmission