Dados do Trabalho

Título

TUBERCULOSIS DIAGNOSIS IN UNDER 15 YEARS: PRESUMPTIVE OR BACTERIOLOGICALLY CONFIRMED PROFILE IN SITES WITH HIGH INCIDENCE

Introdução

The 2022 Brazilian tuberculosis (TB) epidemiological bulletin reported that 72.3% of individuals positive for TB had a diagnosis through one of these methods of analysis: rapid molecular test, bacilloscopy or sputum culture. Diagnosis in children under 15 years old is a challenge. Also, they are at greater risk of severe tuberculosis, particularly children younger than five years and without BCG vaccine.

Objetivo (s)

We aimed to describe the profile of tuberculosis diagnosis in under 15 years (presumptive or bacteriologically confirmed) in brazilian sites with high incidence.

Material e Métodos

Cross-sectional study in 22 Brazilian local sites. Children between 6 months to <15 years old were enrolled in two types of health services (hospitals and TB clinics) from December 2021 to mid-May 2023. The main inclusion criteria were admission for lower respiratory tract infection in hospitalized participants and suspected tuberculosis in outpatients. All participants underwent sputum collection to detect mycobacterium tuberculosis detection. Samples were analyzed by Xpert MTB/RIF Ultra (GeneXpert® Cepheid) and liquid culture (using the Mycobacteria Growth Indicator Tube - MGIT method). The subjects who could not spit spontaneously had the collection done by induced sputum (IS). The positivity of Xpert MTB/RIF Ultra was defined as: detected or trace-positive. The presumptive diagnosis refers to a patient who presents with symptoms or signs suggestive of TB, despite the negative Xpert MTB/RIF Ultra and MGIT results.

Resultados e Conclusão

486 participants were screened and 406 were included, with a median age of 3.8 (IQR: 1.7-7.0). 39/406 (9.6%) were TB positive (bacteriological or presumptive diagnosis). 19/39 (48.7%) were laboratory confirmed: 5 children were attended in TB specialized clinics and 14 admitted in hospitals. The other 20 participants had presumptive TB diagnosis, despite the negative results (Xpert MTB/RIF Ultra and MGIT): 16 children from TB specialized clinics and 4 hospitalized. These preliminary results indicated that children attended in TB specialized clinics had 41% of presumptive diagnosis and 12.8% of laboratory confirmed diagnosis, while the admitted ones had 10.3% and 35.9% of presumptive and confirmed diagnosis respectively.

Palavras-chave

Tuberculosis diagnosis, bacteriologically confirmed, presumptive, children.

Agradecimentos

This work was supported by the PROADI-SUS in collaboration with Hospital Moinhos de Vento.