Diagnosis of Tuberculosis among Children and Adolescents

The authors discuss the challenging aspects of the diagnosis of tuberculosis in children and adolescents, since there is no gold standard for its diagnosis. The different clinical and radiological presentations and the low bacteriological positivity of tuberculosis in childhood are grounds for confrontation to the present. Immunological tests called interferon gamma release assays (IGRAs) failed to overcome the tuberculin skin test in practice. Advances with nucleic acid amplification tests, on the other hand, have contributed to the diagnosis of tuberculosis among adolescents. Standardized systems for diagnosis can be useful as tools for screening or for decision‐making in childhood tuberculosis

Avaliação retrospectiva de sistema de pontuação pelo Ministério da Saúde do Brasil, no diagnóstico de tuberculose pulmonar na criança: estudo controle de casos

Based on a retrospective case-control study we evaluated the score system adopted by the Ministry of Health of Brazil (Ministério da Saúde - MS), to diagnose pulmonary tuberculosis (PTB) in childhood. This system is independent of bacteriological or histopathological data to define a very likely (>; or = 40 points), possible (30-35 points) or unlikely (;10mm (OR = 8.23). The best cut-off point to the diagnosis of PTB was 30 points, where the score system was more accurate, with sensitivity of 88.9% and specificity of 86.5%.Avaliou-se o sistema de pontuação adotado pelo Ministério da Saúde do Brasil para o diagnóstico de tuberculose pulmonar (TP) na infância através de estudo caso-controle retrospectivo. Tal sistema independe de dados bacteriológicos ou histopatológicos e define o diagnóstico de tuberculose como muito provável (>; ou = 40 pontos); possível (30 a 35 pontos) ou pouco provável (; 10 mm (OR = 8,23). O melhor ponto de corte para o diagnóstico de TP foi 30 pontos, no qual houve maior acurácia do sistema, com sensibilidade de 99,9% e especificidade de 86,5%

Radiologic findings of pulmonary tuberculosis in adolescents

AbstractObjectiveTo describe radiologic findings of pulmonary tuberculosis (TB) in adolescents.MethodsRetrospective, cross-sectional, observational study of 850 patients with TB, aged 10 to 19 years, and notified to the Brazilian Ministry of Health. Data were collected from the TB notification and medical records in the cities of Manaus, Amazonas State, and Salvador, Bahia State, in the 1996–2003 period. Data are shown in tables and analyzed using the chi-square and Mann-Whitney tests, with a 5% significance level.ResultsMean age was 15.6 years; 443 (52.1%) patients were males. The most common radiologic lesion was the upper pulmonary lobe infiltrate (53.3%), and isolated cavitation was found in 32.4% of the patients. Both lungs were affected in 29.2% of the patients. The finding of bilateral radiologic lesions was significantly associated with longer disease duration (p = 0.0005).ConclusionsPulmonary TB in adolescents has similar characteristics to TB in adults, evidencing the important role played by adolescents in community disease transmission

Tuberculose em adolescentes em duas capitais brasileiras

Analisamos o perfil clínico-radiológico da tuberculose (TB) em adolescentes de duas capitais brasileiras, segundo a revisão de 2010 das normas do Programa Nacional de Controle da Tuberculose; estudo descritivo, retrospectivo, transversal de casos notificados de TB em Manaus e Salvador, de 1996 a 2003, em dois grupos: 10 a 14 anos e &#8805; 15 a 19 anos com estatística descritiva. Havia 1.781 adolescentes [928 (52,1%) do sexo masculino]. A média de idade = 16 anos (mediana = 16; DP = 2,3). Encontramos 1.447 (82,9%) pacientes com TB pulmonar; 179 (10,3%) com TB pleural e 81 (4,6%) com ganglionar periférica. A tosse ocorreu mais no grupo &#8805; 15 anos (p < 0,001). A baciloscopia foi positiva em 150 (72,1%) com TB pulmonar no grupo de 10 a 14 anos, e em 870 (84,4%) no grupo de &#8805; 15 anos. Havia radiografias de tórax do tipo adulto em 1.088 (98.6%) no grupo de &#8805; 15 anos, e em 58 (98.1%) no grupo < 15 anos (p < 0.0001). Houve tendência à maior ocorrência de TB bacteriológica do tipo adulto na medida em que o paciente aumentava de idade

Cad. Saúde Pública

Analisamos o perfil clínico-radiológico da tuberculose (TB) em adolescentes de duas capitais brasileiras, segundo a revisão de 2010 das normas do Programa Nacional de Controle da Tuberculose; estudo descritivo, retrospectivo, transversal de casos notificados de TB em Manaus e Salvador, de 1996 a 2003, em dois grupos: 10 a 14 anos e ≥ 15 a 19 anos com estatística descritiva. Havia 1.781 adolescentes [928(52,1%) do sexo masculino]. A média de idade = 16 anos (mediana = 16; DP = 2,3). Encontramos 1.447 (82,9%) pacientes com TB pulmonar; 179 (10,3%) com TB pleural e 81 (4,6%) com ganglionar periférica. A tosse ocorreu mais no grupo ≥ 15 anos (p < 0,001). A baciloscopia foi positiva em 150 (72,1%) com TB pulmonar no grupo de 10 a 14 anos, e em 870 (84,4%) no grupo de ≥ 15 anos. Havia radiografias de tórax do tipo adulto em 1.088 (98.6%) no grupo de ≥ 15 anos, e em 58 (98.1%) no grupo < 15 anos (p < 0.0001). Houve tendência à maior ocorrência de TB bacteriológica do tipo adulto na medida em que o paciente aumentava de idade.Rio de Janeir

Braz J Infect Dis

Objective: To describe radiologic findings of pulmonary tuberculosis (TB) in adolescents. Methods: Retrospective, cross-sectional, observational study of 850 patients with TB, aged 10 to 19 years, and notifi ed to the Brazilian Ministry of Health. Data were collected from the TB notification and medical records in the cities of Manaus, Amazonas State, and Salvador, Bahia State, in the 1996-2003 period. Data are shown in tables and analyzed using the chi-square and Mann-Whitney tests, with a 5% signifi cance level. Results: Mean age was 15.6 years; 443 (52.1%) patients were males. The most common radiologic lesion was the upper pulmonary lobe infi ltrate (53.3%), and isolated cavitation was found in 32.4% of the patients. Both lungs were affected in 29.2% of the patients. The finding of bilateral radiologic lesions was signifi cantly associated with longer disease duration (p = 0.0005). Conclusions: Pulmonary TB in adolescents has similar characteristics to TB in adults,evidencing the important role played by adolescents in community disease transmission.Salvado

Brazilian Journal of Infectious Diseases

Texto completo: acesso restrito. p. 40-44OBJECTIVE: To describe radiologic findings of pulmonary tuberculosis (TB) in adolescents. METHODS: Retrospective, cross-sectional, observational study of 850 patients with TB, aged 10 to 19 years, and notified to the Brazilian Ministry of Health. Data were collected from the TB notification and medical records in the cities of Manaus, Amazonas State, and Salvador, Bahia State, in the 19962003 period. Data are shown in tables and analyzed using the chi-square and Mann-Whitney tests, with a 5% significance level. RESULTS: Mean age was 15.6 years; 443 (52.1%) patients were males. The most common radiologic lesion was the upper pulmonary lobe infiltrate (53.3%), and isolated cavitation was found in 32.4% of the patients. Both lungs were affected in 29.2% of the patients. The finding of bilateral radiologic lesions was significantly associated with longer disease duration (p = 0.0005). CONCLUSIONS: Pulmonary TB in adolescents has similar characteristics to TB in adults, evidencing the important role played by adolescents in community disease transmission