A comparison of tuberculosis diagnostic systems in a retrospective cohort of HIV-infected children in Rio de Janeiro, Brazil
| Autor: | Maria de Fátima Bazhuni Pombo March, Clemax Couto Sant'Anna, Solange G. David, Afranio Lineu Kritski, Thalita G. Abreu, Antonio Ruffino Netto, Kathryn L. Lovero |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Microbiology (medical)
Male Pediatrics medicine.medical_specialty Tuberculosis TB-HIV co-infection Adolescent HIV Infections Diagnostic system Sensitivity and Specificity Article lcsh:Infectious and parasitic diseases Cohort Studies 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Hiv infected Medicine Humans lcsh:RC109-216 030212 general & internal medicine Medical diagnosis Diagnostic screening Child Tuberculosis Pulmonary Retrospective Studies business.industry Coinfection Diagnostic Tests Routine Gold standard Infant Retrospective cohort study TB–HIV co-infection General Medicine medicine.disease Pediatric TB Infectious Diseases 030228 respiratory system Child Preschool Cohort TB scoring systems Female business Brazil |
| Zdroj: | International Journal of Infectious Diseases, Vol 59, Iss C, Pp 150-155 (2017) International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases |
| ISSN: | 1878-3511 1201-9712 |
| Popis: | Summary Objectives The diagnosis of pediatric tuberculosis (TB) presents many challenges, and is further complicated in HIV-infected patients. While many diagnostic systems have been proposed, there is no pediatric TB diagnosis gold standard. The outcomes of four TB diagnostic systems in HIV-infected children were compared in this study. Methods A retrospective cohort study was conducted at a TB/HIV reference hospital in Rio de Janeiro. HIV-infected pediatric patients evaluated for TB from 1998 to 2010 were reassessed using four diagnostic systems: Kenneth Jones, 1969; Tidjani, 1986; Ben Marais, 2006; Brazilian Ministry of Health, 2010. Results were compared to standardized diagnoses made by an expert panel of physicians. Results Of the 121 patients in the study cohort, the expert panel diagnosed 64 as TB and 57 as not TB cases. The Tidjani system showed the highest diagnostic accuracy, with and without the inclusion of microbiological data. The Tidjani and Kenneth Jones systems produced fewer false-positives, and the Ben Marais and Ministry of Health fewer false-negatives. Across systems, there was little agreement between TB diagnoses. Conclusions In HIV-infected pediatric patients, the Ben Marais and Ministry of Health systems are useful for TB diagnostic screening, whereas the Tidjani and Kenneth Jones systems are best used in a reference center setting. |
| Databáze: | OpenAIRE |
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