Maciel Ethel Leonor Noia, Dietze Reynaldo, Silva Rita Elizabeth Checon de Freitas, Hadad David Jamil, Struchiner Claudio Jose
Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brasil.
Cad Saude Publica. 2008 Feb;24(2):402-8. doi: 10.1590/s0102-311x2008000200019.
Tuberculosis is currently one of the main causes of death in the world. One of the difficulties for tuberculosis diagnosis in childhood is the bacteriological identification of Mycobacterium tuberculosis. This nested case-control study aimed to compare the diagnostic values of a scoring system proposed by the Brazilian Ministry of Heath for diagnosis of childhood tuberculosis using gastric washing samples taken in the outpatient and hospital settings. A total of 108 children underwent gastric washing (53 with and 55 without tuberculosis). The scoring system proposed by the Brazilian Ministry of Heath for diagnosis of tuberculosis in children with negative sputum smears showed good sensitivity in both groups, and the best cutoff point was "1" (possible tuberculosis), with 92% sensitivity, thus feasible for use as an ancillary diagnostic test in children submitted to gastric washing. Our recommendation is that the Ministry of Health scoring system be used by health services to assist the physician in deciding on whether to continue the investigation of childhood tuberculosis, and not only in children who have already undergone the procedure and who have shown negative results.
结核病是目前全球主要死因之一。儿童结核病诊断的困难之一在于结核分枝杆菌的细菌学鉴定。这项巢式病例对照研究旨在比较巴西卫生部提出的一种评分系统对在门诊和医院环境中采集的洗胃样本诊断儿童结核病的诊断价值。共有108名儿童接受了洗胃(53名患有结核病,55名未患结核病)。巴西卫生部提出的用于痰涂片阴性儿童结核病诊断的评分系统在两组中均显示出良好的敏感性,最佳截断点为“1”(可能患有结核病),敏感性为92%,因此可作为接受洗胃儿童的辅助诊断测试。我们建议卫生服务部门使用卫生部的评分系统,以协助医生决定是否继续对儿童结核病进行调查,而不仅仅用于已经接受该程序且结果为阴性的儿童。