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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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The diagnosis of tuberculosis
1Department of Infectious Diseases, Great Ormond Street Hospital, Great Ormond Street, London, United Kingdom. shingd@gosh.nhs.uk
The Pediatric Infectious Disease Journal
|February 15, 2012
Summary
Diagnosing childhood tuberculosis is challenging due to low bacterial counts and difficulty obtaining sputum. Current methods, including new immune-based assays, show limited improvement for active disease detection, highlighting the need for better diagnostic tools for pediatric tuberculosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Childhood tuberculosis represents a substantial global health burden.
- Pediatric tuberculosis diagnosis is complicated by paucibacillary nature and challenges in sample collection, particularly sputum.
Purpose of the Study:
- To review current and emerging diagnostic strategies for childhood tuberculosis.
- To evaluate the utility of newer diagnostic methods, including immune-based assays, in pediatric populations.
Main Methods:
- Review of traditional diagnostic methods: chest radiography, tuberculin skin testing, and mycobacterial culture.
- Inclusion of newer bacteriologic, molecular, and immune-based diagnostic approaches.
- Discussion of advancements in pediatric sample collection techniques.
Main Results:
- Traditional methods remain foundational but have limitations.
- Interferon-gamma release assays (IGRAs) show potential for excluding false positives from tuberculin skin tests but do not significantly improve sensitivity for active disease.
- Newer methods offer incremental improvements but do not fully address diagnostic challenges.
Conclusions:
- Accurate diagnosis of tuberculosis in children remains a significant clinical challenge.
- Existing diagnostic tools, including newer immune-based assays, have limitations in sensitivity for active pediatric tuberculosis.
- Further research and development of novel diagnostic tests are crucial for improving tuberculosis management in children.
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