title: Challenges in diagnosing tuberculosis in children: a comparative study from Sudan.
abstract: OBJECTIVE
  The diagnosis of tuberculosis (TB) in children is challenging due to insufficient specimen material and the scarcity of bacilli in specimens. This study aimed to evaluate methods for diagnosing TB in children in Sudan.
  
  
  METHODS
  Patients (N=197) were subjected to the tuberculin skin test (TST). Gastric lavage or sputum specimens were then collected, processed, and cultured as per standard procedures.
  
  
  RESULTS
  Culture on Löwenstein-Jensen medium, the reference standard, revealed growth in 16.2% of the specimens. Comparative analysis showed that 43.7% were positive for the TST (sensitivity 100%, specificity 67.3%), 8.1% were positive by Ziehl-Neelsen stain (sensitivity 43.8%, specificity 98.8%), 11.2% by auramine stain (sensitivity 56.3%, specificity 98.8%), and 17.8% were positive for PCR amplification of the IS6110 sequence (sensitivity 100%, specificity 98.8%).
  
  
  CONCLUSIONS
  It is concluded that whilst TST and IS6110 achieved 100% sensitivity based on the reference standard of culture, the latter was more specific. The TST is recommended for routine diagnosis and the use of PCR for particular cases, depending on the facilities and the urgency.
authors.affiliation: Department of Medical Laboratory Technology, College of Applied Medical Sciences, Taibah University, PO Box 344, Al Madenah Al Monawarah, Saudi Arabia; Department of Medical Microbiology, College of Medical Laboratory Science, Sudan University of Science and Technology, Sudan. Electronic address: mogahidelhassan@yahoo.com.
authors.forename: Mogahid M
authors.initials: MM
authors.lastname: Elhassan
authors.affiliation: Department of Medical Laboratory Technology, College of Applied Medical Sciences, Taibah University, PO Box 344, Al Madenah Al Monawarah, Saudi Arabia; Department of Medical Microbiology, College of Medical Laboratory Science, Sudan University of Science and Technology, Sudan.
authors.forename: Miskelyemen A
authors.initials: MA
authors.lastname: Elmekki
authors.affiliation: Department of Medical Laboratory Sciences, College of Allied Health Sciences, Gulf Medical University, Ajman, UAE.
authors.forename: Ahmed L
authors.initials: AL
authors.lastname: Osman
authors.affiliation: Department of Clinical Microbiology and Parasitology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Hamid
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003470:Culture Media; D006801:Humans; D007223:Infant; D008297:Male; D008853:Microscopy; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D013397:Sudan / Q000453:epidemiology; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D003470:Culture Media
keywords: Childhood tuberculosis; Gastric lavage; Khartoum; Sputum; Sudan; TB laboratory diagnosis IS6110