Comparison of Minimally Invasive Tissue Sampling With Conventional Autopsy to Detect Pulmonary Pathology Among...

Area of Science:

• Pediatric Pathology
• Infectious Disease Diagnostics
• Global Health

Background:

• Respiratory diseases are a leading cause of mortality in children under 5, particularly in resource-limited settings.
• Accurate diagnosis is crucial for effective treatment and public health interventions.
• Conventional autopsy (CA) may be limited by cultural factors or resource constraints.

Purpose of the Study:

• To compare the diagnostic yield of minimally invasive tissue sampling (MITS) with conventional autopsy (CA).
• To evaluate MITS for detecting respiratory pathology and pathogens in children under 5 years in Kenya.
• To assess the concordance between MITS and CA for histological and molecular findings.

Main Methods:

• Pulmonary MITS was performed, followed by CA in 64 children under 5 with respiratory disease.
• Lung tissues were analyzed using histology and molecular testing (TaqMan Array Cards).
• Diagnostic adequacy and concordance between MITS and CA were statistically compared.

Main Results:

• Adequate tissue for diagnosis was obtained via MITS in 84% of cases.
• Histological analysis showed 66% overall concordance between MITS and CA.
• Molecular testing for pathogens demonstrated 80% overall concordance between MITS and CA.

Conclusions:

• MITS is a viable and effective alternative to CA for diagnosing respiratory deaths in resource-limited settings.
• Combining MITS with ancillary tests like molecular diagnostics enhances diagnostic accuracy.
• MITS offers a practical approach to improving pediatric respiratory disease surveillance and diagnosis globally.