A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study
Main Author: | |
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Publication Date: | 2003 |
Other Authors: | , |
Format: | Article |
Language: | eng |
Source: | Revista do Instituto de Medicina Tropical de São Paulo |
Download full: | https://www.revistas.usp.br/rimtsp/article/view/30688 |
Summary: | Based on a retrospective case-control study we evaluated the score system adopted by the Ministry of Health of Brazil (Ministério da Saúde - MS), to diagnose pulmonary tuberculosis (PTB) in childhood. This system is independent of bacteriological or histopathological data to define a very likely (>; or = 40 points), possible (30-35 points) or unlikely (< or = 25 points) diagnosis of tuberculosis. Records of hospitalized non-infected HIV children at the Instituto de Puericultura e Pediatria Martagão Gesteira of Federal University of Rio de Janeiro (IPPMG-UFRJ), were reviewed. Patients were adjusted for age and divided in two different groups: 45 subjects in the case group (culture-positive) [mean of age = 10.64 mo; SD 9.66]; and 96 in the control group (culture-negative and clinic criteria that dismissed the disease) [mean of age = 11.79 mo.; SD 11.31]. Among the variables analyzed, the radiological status had the greater impact into the diagnosis (OR = 25.39), followed by exposure to adult with tuberculosis (OR = 10.67), tuberculin skin test >;10mm (OR = 8.23). The best cut-off point to the diagnosis of PTB was 30 points, where the score system was more accurate, with sensitivity of 88.9% and specificity of 86.5%. |
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A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study Avaliação retrospectiva de sistema de pontuação pelo Ministério da Saúde do Brasil, no diagnóstico de tuberculose pulmonar na criança: estudo controle de casos Pulmonary tuberculosisChildCase-control study Based on a retrospective case-control study we evaluated the score system adopted by the Ministry of Health of Brazil (Ministério da Saúde - MS), to diagnose pulmonary tuberculosis (PTB) in childhood. This system is independent of bacteriological or histopathological data to define a very likely (>; or = 40 points), possible (30-35 points) or unlikely (< or = 25 points) diagnosis of tuberculosis. Records of hospitalized non-infected HIV children at the Instituto de Puericultura e Pediatria Martagão Gesteira of Federal University of Rio de Janeiro (IPPMG-UFRJ), were reviewed. Patients were adjusted for age and divided in two different groups: 45 subjects in the case group (culture-positive) [mean of age = 10.64 mo; SD 9.66]; and 96 in the control group (culture-negative and clinic criteria that dismissed the disease) [mean of age = 11.79 mo.; SD 11.31]. Among the variables analyzed, the radiological status had the greater impact into the diagnosis (OR = 25.39), followed by exposure to adult with tuberculosis (OR = 10.67), tuberculin skin test >;10mm (OR = 8.23). The best cut-off point to the diagnosis of PTB was 30 points, where the score system was more accurate, with sensitivity of 88.9% and specificity of 86.5%. Avaliou-se o sistema de pontuação adotado pelo Ministério da Saúde do Brasil para o diagnóstico de tuberculose pulmonar (TP) na infância através de estudo caso-controle retrospectivo. Tal sistema independe de dados bacteriológicos ou histopatológicos e define o diagnóstico de tuberculose como muito provável (>; ou = 40 pontos); possível (30 a 35 pontos) ou pouco provável (< ou + 25 pontos). Foram revisados os prontuários de crianças não infectadas pelo HIV internadas no Instituto de Puericultura e Pediatria Martagão Gesteira da Universidade Federal do Rio de Janeiro; os pacientes foram ajustados por idade e divididos em dois grupos: 45 casos (cultura positiva) [média = 10,64 meses; DP 9,66]; e 96 controles (cultura negativa e sem critérios clínicos para TP) [média = 11,79 meses; DP 11,31]. Dentre as variáveis analisadas, o quadro radiológico teve grande importância para o diagnóstico (OR = 25,39), seguido pelo contato com adulto com tuberculose (OR = 10,67), teste tuberculínico >; 10 mm (OR = 8,23). O melhor ponto de corte para o diagnóstico de TP foi 30 pontos, no qual houve maior acurácia do sistema, com sensibilidade de 99,9% e especificidade de 86,5%. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2003-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30688Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 No. 2 (2003); 103-105 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 Núm. 2 (2003); 103-105 Revista do Instituto de Medicina Tropical de São Paulo; v. 45 n. 2 (2003); 103-105 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30688/32572Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessSant'Anna, Clemax CoutoOrfaliais, Cláudia T. S.March, Maria de Fátima B. Pombo2012-07-07T18:01:26Zoai:revistas.usp.br:article/30688Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:27.419243Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study Avaliação retrospectiva de sistema de pontuação pelo Ministério da Saúde do Brasil, no diagnóstico de tuberculose pulmonar na criança: estudo controle de casos |
title |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study |
spellingShingle |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study Sant'Anna, Clemax Couto Pulmonary tuberculosis Child Case-control study |
title_short |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study |
title_full |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study |
title_fullStr |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study |
title_full_unstemmed |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study |
title_sort |
A retrospective evaluation of a score system adopted by the Ministry of Health, Brazil in the diagnosis of pulmonary tuberculosis in childhood: a case control study |
author |
Sant'Anna, Clemax Couto |
author_facet |
Sant'Anna, Clemax Couto Orfaliais, Cláudia T. S. March, Maria de Fátima B. Pombo |
author_role |
author |
author2 |
Orfaliais, Cláudia T. S. March, Maria de Fátima B. Pombo |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Sant'Anna, Clemax Couto Orfaliais, Cláudia T. S. March, Maria de Fátima B. Pombo |
dc.subject.por.fl_str_mv |
Pulmonary tuberculosis Child Case-control study |
topic |
Pulmonary tuberculosis Child Case-control study |
description |
Based on a retrospective case-control study we evaluated the score system adopted by the Ministry of Health of Brazil (Ministério da Saúde - MS), to diagnose pulmonary tuberculosis (PTB) in childhood. This system is independent of bacteriological or histopathological data to define a very likely (>; or = 40 points), possible (30-35 points) or unlikely (< or = 25 points) diagnosis of tuberculosis. Records of hospitalized non-infected HIV children at the Instituto de Puericultura e Pediatria Martagão Gesteira of Federal University of Rio de Janeiro (IPPMG-UFRJ), were reviewed. Patients were adjusted for age and divided in two different groups: 45 subjects in the case group (culture-positive) [mean of age = 10.64 mo; SD 9.66]; and 96 in the control group (culture-negative and clinic criteria that dismissed the disease) [mean of age = 11.79 mo.; SD 11.31]. Among the variables analyzed, the radiological status had the greater impact into the diagnosis (OR = 25.39), followed by exposure to adult with tuberculosis (OR = 10.67), tuberculin skin test >;10mm (OR = 8.23). The best cut-off point to the diagnosis of PTB was 30 points, where the score system was more accurate, with sensitivity of 88.9% and specificity of 86.5%. |
publishDate |
2003 |
dc.date.none.fl_str_mv |
2003-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30688 |
url |
https://www.revistas.usp.br/rimtsp/article/view/30688 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30688/32572 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 No. 2 (2003); 103-105 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 Núm. 2 (2003); 103-105 Revista do Instituto de Medicina Tropical de São Paulo; v. 45 n. 2 (2003); 103-105 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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