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Diagnosis of intra-thoracic tuberculosis (ITTB) in children is difficult due to the paucibacillary nature of the disease, the challenge in collecting appropriate specimens, and the low sensitivity of smear microscopy and culture. Culture and Xpert MTB/RIF provide higher diagnostic yield in presumptive TB in adults than in children. Current study was designed to understand poor yield of diagnostic assays in children. Children with presumptive ITTB were subjected to gastric aspirates and induced sputum twice. Samples were tested by Ziehl-Neelsen stain, Xpert MTB/RIF-assay, and MGIT-960 culture. Subjects were grouped as Confirmed, Unconfirmed, and Unlikely TB, and classified as progressive primary disease (PPD, lung parenchymal lesion), and primary pulmonary complex (PPC, hilar lymphadenopathy) on chest X-ray. Of children with culture-positive TB 51/394 (12.9%), culture-negative TB 305 (77.4%), and unlikely TB 38 (9.6%), 9 (2.3%) were smear positive, while 95 (24.1%) were Xpert-MTB/RIF positive. Xpert-MTB/RIF detected 40/51 culture confirmed cases (sensitivity 78.4% and NPV 96.3%). Culture was positive in more children presenting as PPD (p < 0.04). In culture-negative TB group, Xpert positivity was seen in 31% of those with PPD and 11.9% in those with PPC (p < 0.001). Conclusion: Xpert-MTB/RIF improved diagnosis by 2-fold and increased detection of MDR-TB. Both liquid culture and Xpert-MTB/RIF gave higher yield in children with lung parenchymal lesions. Children with hilar lymphadenopathy without active lung parenchymal lesions had poor diagnostic yield even with sensitive nucleic acid amplification tests, due to paucibacillary/localized disease, suggesting possible utility of invasively collected samples in early diagnosis and treatment.

Diagnosis of intra-thoracic tuberculosis (ITTB) in children is difficult due to the paucibacillary nature of the disease, the challenge in collecting appropriate specimens, and...

September 28, 2021

A nexus of miR-1271, PAX4 and ALK/RYK influences the cytoskeletal architectures in Alzheimer’s Disease and Type 2 Diabetes

November 16, 2021
Mycobacterium tuberculosis Rv0927c Inhibits NF-κB Pathway by Downregulating the Phosphorylation Level of IκBα and Enhances Mycobacterial Survival
Biology Cells

Mycobacterium tuberculosis Rv0927c Inhibits NF-κB Pathway by Downregulating the Phosphorylation Level of IκBα and Enhances...

September 25, 2021
slco1a1, Time Course of Renal Transcriptomics after Subchronic Exposure to Ochratoxin A in Fisher Rats
Biology Cells

Time Course of Renal Transcriptomics after Subchronic Exposure to Ochratoxin A in Fisher Rats

November 16, 2021
Dermal adipose tissue secretes HGF to promote human hair growth and pigmentation
Biology Cells

Dermal adipose tissue secretes HGF to promote human hair growth and pigmentation

October 5, 2021
The Growing Importance of Tuberculosis Preventive Therapy and How Research and Innovation Can Enhance Its Implementation on the Ground.
Biology Cells

The Growing Importance of Tuberculosis Preventive Therapy and How Research and Innovation Can Enhance Its...

February 3, 2021
qpcr covid, SARS-CoV-2 UK, South African and Brazilian Variants in Karachi- Pakistan
Biology Cells

SARS-CoV-2 UK, South African and Brazilian Variants in Karachi- Pakistan

November 16, 2021
A Survey of Latent Tuberculosis Screening and Treatment Practices in a Tertiary Centre
Biology Cells

A Survey of Latent Tuberculosis Screening and Treatment Practices in a Tertiary Centre

September 27, 2021
glycophorin b, High-throughput genotyping assays for identification of glycophorin B deletion variants in population studies
Biology Cells

High-throughput genotyping assays for identification of glycophorin B deletion variants in population studies

November 16, 2021
Hsp70 exerts oncogenic activity in the Apc mutant Min mouse model.
Biology Cells

Hsp70 exerts oncogenic activity in the Apc mutant Min mouse model.

October 5, 2021
Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults.
Biology Cells

Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults.

February 3, 2021
Real-Time Spatial and Temporal Analysis of the Translocation of the Apoptosis-Inducing Factor in Cells
Biology Cells

Real-Time Spatial and Temporal Analysis of the Translocation of the Apoptosis-Inducing Factor in Cells

November 16, 2021
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