CONCORDANCE OF THE SCORING SYSTEM AND GENE-XPERT MTB/RIF TO DIAGNOSE CHILDHOOD TUBERCULOSIS IN PRIMARY HEALTH CARE
DOI:
https://doi.org/10.54209/jurnaleduhealth.v12i02.162Abstract
The Scoring system developed by the Indonesian childhood tuberculosis working group is an alternative way to clinically diagnose TB in children especially in primary health care, however, bacteriological confirmation using gene-Xpert MTB/RIF is still highly recommended. To compare childhood TB scoring system performance and gene-Xpert MTB/RIF results among children suspected of tuberculosis in primary health care. This study was conducted on 47 children who went to the primary health care facility. The design of this study was a cross-sectional study with a conformity test (kappa). Samples that meet the inclusion criteria are recorded in the form of age, gender, weight, height, nutritional status, previous history of BCG vaccination, and physical examination, then the data is entered into the scoring system. Sputum is obtained by induction and then examined using gene-Xpert. The number of boys and girls suspected of having pulmonary TB is almost the same. About 72% of children experience malnutrition and a positive BCG score is found in more than half of the samples. There were 51.1% of children in contact with positive smear adult TB patients. Based on the scoring system obtained a TB diagnosis of 74.5% whereas based on gene-Xpert MTB/RIF examination only 4.3% of children confirm TB. There is no match between the two (conformity test with the kappa values of -0.01 and suitability 0.397). There is no compatibility in making a diagnosis of pediatric tuberculosis between the scoring system and gene-Xpert MTB/RIF at the primary health care facility.
References
Avalos GGL. Classic and new diagnostic approaches to childhood tuberculosis. J Tropic Med. 2102;1-12.
Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia. Petunjuk Teknis Manajemen TB Anak. Jakarta: Kementrian Kesehatan RI; 2013.
Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia. TB Anak. 2013 (diunduh 2015). Tersedia dari: www.tbindonesia.or.id
Boehme CC NM, Nabeta P, Michael JS, Gotuzzo E, Tahirli R, et al. Feasibility, diagnostic accuracy, and eff ectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study. Lancet. 2011;377:1495-505.
Lawn SD NM. Xpert MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol. 2011;6:1067-82.
WHO. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children Policy update. Geneva: WHO;2013.
TB CARE I. International standards for tuberculosis care, Edition 3. USA:TB CARE I; 2014.
Sekadde MP WE, Joloba ML, Sengoba W, Kisembo H, Kittaka SB. Evaluation of the expert MTB/RIF test for the diagnosis ofchildhood pulmonary tuberculosis in Uganda: a cross-sectional diagnostic study. BMC infectious disease. 2013;13:1-8.
Salazar GE ST, Cama R, Sheen P, Franchi LM, Centeno G, et al. Pulmonary tuberculosis in children in a developing country. Pediatrics. 2001;108:448-53.
Perez-Velez CM MB. Tuberculosis in children. The New England Journal of Medicine. 2012:348-61.
Nursyamsi RM. Tbc dengan tes mantoux di bagian ilmu kesehatan anak RSU Prof. Dr.dr.Kandou Manado periode 2001-2006. INSPIRASI 2011;XIV:65-90.
Sawhney CM SM. Significance of Tuberculin Testing in HIV Infection: An Indian Perspective. MJAFI. 2006;62:104-7.
Astuti S, Reviono, Wachid P, Kesesuaian pemeriksaan tuberculin skin test dan T-SPOT.TB serta sensitivitas dan spesifisitas T-SPOT.TB dalam mendeteksi infeksi tuberkulosis laten pada pasien hemodialisis. J Respir Indo.2021;41(1):19-27.
Jain SK OA, Kinikar A, Gupte N, Thakar M, Mave V. Pediatric tuberculosis in young children in India: A Prospective study. Biomed research Int. 2013:1-8.
Triasih R GS. Limitations of the Indonesian Pediatric Tuberculosis Scoring system in the context of child contact investigation. Paediatrica Indonesiana. 2011;51:332-7.
Suryanarayana L JP. Scoring method for diagnosis of tuberculosis in children: an evaluation. Ind J Tub. 2001;48:101-3.
Giang DC DT, Ha DTM, Nha HT, Wolbers M, Nhu NTQ, et al. Prospective evaluation of gene xpert for the diagnosis of HIV-negative pediatric TB case. BMC infectious disease. 2015;15:1-10.
Rahajoe NN SD. Patogenesis dan perjalanan alamiah tuberkulosis. In: Rahajoe NN SB, Setyanto DB, ed. Buku ajar respirologi anak. 1 ed. Jakarta: Badan Penerbit IDAI; 2010:169-77.
