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Nasopharyngeal aspiration for diagnosis of pulmonary tuberculosis

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Owens, S., Abdel-Rahman, I. E., Balyejusa, S., Musoke, P., Cooke, R. P. D., Parry, C. M. and Coulter, John B.S. (2007) 'Nasopharyngeal aspiration for diagnosis of pulmonary tuberculosis'. Archives of Disease in Childhood, Vol 92, Issue 8, pp. 693-696.

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Abstract

Background: Confirmation of pulmonary tuberculosis (PTB) in young children is difficult as they seldom expectorate sputum.
Aim: To compare sputa obtained by nasopharyngeal aspiration and by sputum induction for staining and culture of Mycobacterium tuberculosis.
Patients and methods: Patients from Mulago Hospital, Kampala with symptoms suggestive of PTB were considered for inclusion in the study. Those with a positive tuberculin test and/ or a chest radiograph compatible with tuberculosis were recruited. Infection with human immunodeficiency virus (HIV) was confirmed by duplicate enzyme-labelled immunosorbent assay or in children,15 months by polymerase chain reaction (PCR). Direct PCR was undertaken on 82 nasopharyngeal aspirates.
Results: Of 438 patients referred, 94 were recruited over a period of 5 months. Median (range) age was 48 (4-144) months. Of 63 patients tested, 69.8% were infected with HIV. Paired and uncontaminated culture results were available for 88 patients and smear results for 94 patients. Nasopharyngeal aspirates were smear-positive in 8.5% and culture-positive in 23.9%. Induced sputa were smear-positive in 9.6% and culture positive in 21.6%. Overall, 10.6% were smear-positive, 25.5% were culture-positive and 26.6% had smear and/or culture confirmed tuberculosis. Direct PCR on nasopharyngeal aspirates had a sensitivity of 62% and specificity of 98% for confirmation of culture-positive tuberculosis.
Conclusions: Nasopharyngeal aspiration is a useful, safe and low-technology method for confirmation of PTB and, like sputum induction, can be undertaken in outpatient clinics.

Item Type: Article
Additional Information: Published version is available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083896/pdf/693.pdf
Uncontrolled Keywords: childhood tuberculosis sputum induction mycobacterium-tuberculosis clinical-features children infants malawi
Subjects: WF Respiratory System > Tuberculosis > WF 300 Pulmonary tuberculosis
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 280 Respiratory system
WS Pediatrics > By Age Groups > WS 421 Diseases of newborn infants
WS Pediatrics > By Age Groups > WS 430 Infancy
WS Pediatrics > By Age Groups > WS 440 Preschool child
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.1136/adc.2007.108308
Depositing User: Pauline Anderson
Date Deposited: 15 Nov 2010 09:59
Last Modified: 06 Feb 2018 13:01
URI: http://archive.lstmed.ac.uk/id/eprint/1261

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