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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.
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Diagnosis of intra-thoracic tuberculosis (ITTB) in children is difficult due to the paucibacillary nature of...

cibacron blue f3ga, Cibacron blue F3GA incorporated immobilized metal chelate affinity sorbent as a high efficient affinity immobilization materials for catalase enzyme
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Cibacron blue F3GA incorporated immobilized metal chelate affinity sorbent as a high efficient affinity immobilization...

Extensively drug-resistant tuberculosis treated with bedaquiline: A case report in the particularly vulnerable tribal group of Madhya Pradesh, India
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Extensively drug-resistant tuberculosis treated with bedaquiline: A case report in the particularly vulnerable tribal group...

CD4 T cell help prevents CD8 T cell exhaustion and promotes control of Mycobacterium tuberculosis infection
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CD4 T cell help prevents CD8 T cell exhaustion and promotes control of Mycobacterium tuberculosis...

slco1a1, Time Course of Renal Transcriptomics after Subchronic Exposure to Ochratoxin A in Fisher Rats
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Time Course of Renal Transcriptomics after Subchronic Exposure to Ochratoxin A in Fisher Rats

TCA cycle remodeling drives proinflammatory signaling in humans with pulmonary tuberculosis
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TCA cycle remodeling drives proinflammatory signaling in humans with pulmonary tuberculosis

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

Biocredit Antigen
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Biocredit Antigen Test

Effect of Isoniazid Preventive Therapy on the Incidence of Tuberculosis among Seropositive Children Attending HIV/AIDS Care in Two General Hospitals, Northwest Ethiopia, 2021
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The Mycobacterium tuberculosis sRNA F6 Modifies Expression of Essential Chaperonins, GroEL2 and GroES

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Tumor Necrosis Receptor Superfamily Interact with Fusion and Fission of Mitochondria of Adipose Tissue in...

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Genome operob chasecm mycobacterium smegmatis Capilia Tauns
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