The objective of this study was to measure agreement between nine structured approaches for diagnosing childhood tuberculosis; to quantify differences in the number of tuberculosis cases diagnosed with the different approaches, and to determine the distribution of cases in different categories of diagnostic certainty.
The authors investigated 1445 children aged
Tuberculosis case frequency ranged from 6.9% to 89.2% (median: 41.7). Significant differences in case frequency (P
The study concluded that there is only slight agreement between structured approaches for the screening and diagnosis of childhood tuberculosis and high variability between them in terms of case yield. Diagnostic systems that yield similarly low case frequencies may be identifying different subpopulations of children. The study findings do not support the routine clinical use of structured approaches for the definitive diagnosis of childhood tuberculosis, although high-yielding systems may be useful screening tools.
Hatherill, M.; Hanslo, M.; Hawkridge, T.; Little, F.; Workman, L.; Mahomed, H.; Tameris, M.; Moyo, S.; Geldenhuys, H.; Hanekom, W.; Geiter, L.; Hussey, G. Structured approaches for the screening and diagnosis of childhood tuberculosis in a high prevalence region of South Africa. Bulletin of the World Health Organization (2010) 88 (4) 312-320. [DOI: 10.2471/BLT.09.062893]