坦桑尼亚中部多多马市艾滋病毒/艾滋病护理和治疗中心就诊的艾滋病毒感染儿童中，结核分枝杆菌培养阳性的流行率和一种临床诊断工具对结核分枝杆菌诊断的实用性。

Prevalence of culture positive Tuberculosis and utility of a clinical diagnostic tool for the diagnosis of Tuberculosis among HIV Infected Children attending HIV/AIDS Care and Treatment in Dodoma Municipality, Central Tanzania.

机构信息

Department of Paediatrics & Child Health, University of Dodoma Tanzania.

出版信息

Int J Infect Dis. 2020 Jul;96:593-599. doi: 10.1016/j.ijid.2020.06.001. Epub 2020 Jun 4.

DOI:10.1016/j.ijid.2020.06.001

PMID:32505876

Abstract

OBJECTIVE

To evaluate the performance of the modified Keith Edwards TB clinical diagnostic tool among HIV infected children.

METHODS

Cross sectional study of 252 HIV infected children < 15 years old suspected with TB at four HIV/AIDS Care Clinics in Dodoma, Tanzania from November 2018 - March 2019. The modified Keith Edwards TB clinical diagnostic tool was compared to gastric aspirates, lymphnode aspirates or sputum gene x-pert MTB/RIF and TB culture. Sensitivity, specificity, negative and positive predictive value of the clinical tool were determined. Data was analyzed using SPSS version 25.

RESULTS

Out of 252 children evaluated, 13.5% (34/252) had TB using the clinical diagnostic tool and 5.2% (13/252) had culture positive TB. The sensitivity of the clinical tool was 76.9%, specificity of 90%. Culture positive TB predictors were lymphadenopathy (AOR 13.74, 95%CI (3.86 - 48.86) p value < 0.001), weight loss (AOR 3.19,95%CI (1.38 - 7.36) p value 0.007), and difficulty breathing (AOR 7.25, 95%CI (1.54 - 34.16) p value 0.012).

CONCLUSION

The utility of the modified Keith Edwards clinical diagnostic tool for Tuberculosis diagnosis among HIV infected children is limited, calling for further validation. HIV infected children with lymphadenopathy, failure to thrive and difficulty in breathing are at high risk of Tuberculosis.

摘要

目的

评估改良 Keith Edwards 结核病临床诊断工具在 HIV 感染儿童中的表现。

方法

2018 年 11 月至 2019 年 3 月，在坦桑尼亚多多马的四家 HIV/AIDS 护理诊所，对 252 名<15 岁疑似患有结核病的 HIV 感染儿童进行了一项横断面研究。将改良 Keith Edwards 结核病临床诊断工具与胃液抽吸物、淋巴结抽吸物或痰液 Gene X-pert MTB/RIF 和结核培养进行比较。确定临床工具的敏感性、特异性、阴性预测值和阳性预测值。使用 SPSS 版本 25 进行数据分析。

结果

在评估的 252 名儿童中，有 13.5%（34/252）使用临床诊断工具患有结核病，5.2%（13/252）有培养阳性结核病。临床工具的敏感性为 76.9%，特异性为 90%。培养阳性结核病的预测因素是淋巴结病（AOR 13.74，95%CI（3.86-48.86）p 值<0.001）、体重减轻（AOR 3.19，95%CI（1.38-7.36）p 值 0.007）和呼吸困难（AOR 7.25，95%CI（1.54-34.16）p 值 0.012）。