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Laryngeal swabs for diagnosing tuberculosis
A Thakur1, J B Coulter, K Zutshi
1Liverpool School of Tropical Medicine, U.K.
Insights
Laryngeal swabs offer a simple method for confirming pulmonary tuberculosis in children. This study found a 33% confirmation rate, suggesting its utility in outpatient settings for diagnosing childhood tuberculosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pediatric tuberculosis diagnosis can be challenging.
- Early confirmation is crucial for effective treatment and public health.
Purpose of the Study:
- To evaluate the effectiveness of laryngeal swabs for confirming pulmonary tuberculosis in Indian children.
- To assess the diagnostic yield of smear and culture from laryngeal swabs.
Main Methods:
- Investigated 116 children with suspected tuberculosis.
- Utilized Mantoux test and chest X-ray for initial screening.
- Collected laryngeal swabs over 3 consecutive days from 51 probable cases.
- Performed smear microscopy and Mycobacterium tuberculosis culture on swabs.
Main Results:
- Pulmonary tuberculosis confirmed in 33% of suspected cases via laryngeal swabs.
- Mycobacterium tuberculosis cultured from 28% of laryngeal swabs.
- Smear positivity was observed in an additional 3 children.
- Mantoux test positive in 73% and chest X-ray abnormal in 71% of probable cases.
Conclusions:
- Laryngeal swabs provide a simple and effective method for confirming pediatric tuberculosis.
- This technique is suitable for use in outpatient settings.
- Laryngeal swab analysis aids in the diagnosis of childhood tuberculosis.
Abstract:
The value of smear and culture of laryngeal swabs as a method of confirming pulmonary tuberculosis was investigated in Indian children. A total of 116 children with 'suspected' tuberculosis had a Mantoux test and chest X-ray. Of these, 51 had a positive Mantoux and/or chest X-ray compatible with tuberculosis, and this group had two laryngeal swabs taken on each of 3 consecutive days. The Mantoux test was positive in 37 (73%) of the 51 'probable' cases. Chest X-ray was abnormal in 36 (71%) cases and compatible with tuberculosis in 20 (39.7%). Mycobacterium tuberculosis was cultured from laryngeal swabs in 14 (28%) children and in another three children smears were positive but culture-negative. The overall confirmation rate for tuberculosis was 33%. Laryngeal swabs are a simple method of confirming tuberculosis and may be undertaken in out-patients.