Mehnaz Aisha, Arif Fehmina
Department of Paediatrics, Dow University of Health Sciences, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2005 Sep;15(9):543-6.
To test the applicability of scoring chart to detect children suffering from tuberculosis.
Case control study.
The study was conducted at the Department of Paediatrics Unit-1, Civil Hospital, Karachi.
Included in this study were 50 children in whom tuberculosis (TB) was diagnosed on the basis of history, physical signs, investigations and positive response to anti-tuberculous therapy. Also included in the study were 50 controls admitted with diagnosis other than tuberculosis. Modified Kenneth Jones Scoring Chart (KJSC) was applied to both the groups of children. These children were given a score of 0-7 or above according to the chart. The sensitivity of various parameters used in the KJSC was also tested in both the groups.
A score of 1-2 (TB unlikely) was found in none of the cases versus 44% in the controls. Score of 5-6 (TB probable) was obtained in 40% of cases and none in the controls. Fifty-six percent cases had a score of 7 or more (TB unquestionable) versus 0% in controls. Contact with an adult suffering from tuberculosis, physical and radiological signs suggestive of tuberculosis and an exaggerated reaction to BCG vaccine emerged as the most important indicators used in the scoring chart to detect children with tuberculosis.
The Kenneth Jones Scoring Chart is a simple cost-effective tool, which can easily be applied to improve the case detection rate in children. In the absence of a gold standard for diagnosing tuberculosis in children and in view of logistic and financial constraints faced by resource constraint countries, like ours, this simple screening tool can be utilized at the health care facilities.
测试评分表在检测儿童结核病方面的适用性。
病例对照研究。
研究在卡拉奇市民医院儿科1病房进行。
本研究纳入50名儿童，这些儿童根据病史、体征、检查及抗结核治疗的阳性反应被诊断为结核病。还纳入了50名诊断为非结核病的对照儿童。对两组儿童均应用改良的肯尼斯·琼斯评分表（KJSC）。根据该评分表给这些儿童打0至7分或更高分数。还在两组中测试了KJSC中使用的各种参数的敏感性。
病例组中无一例得1至2分（结核病可能性小），而对照组中有44%得此分数。40%的病例组得5至6分（结核病有可能），对照组中无人得此分数。56%的病例组得7分或更高分（结核病确定无疑），而对照组中为0%。与患结核病的成年人接触、提示结核病的体征和放射学表现以及对卡介苗的超敏反应是评分表中用于检测儿童结核病的最重要指标。
肯尼斯·琼斯评分表是一种简单且经济有效的工具，可轻松应用以提高儿童病例检出率。鉴于在儿童结核病诊断方面缺乏金标准，且鉴于像我们这样资源有限的国家面临后勤和财政限制，这种简单的筛查工具可在医疗机构使用。
