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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Diagnostic features associated with culture of mycobacterium tuberculosis among young children in a vaccine trial setting
Pediatric Infectious Disease Journal, Volume 31, No. 1, Year 2012
Notification
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Description
Objectives: To identify diagnostic features associated with culture of Mycobacterium tuberculosis (MTB), the standard for tuberculosis (TB) diagnosis, to inform clinical end point definitions for new TB vaccine trials. Methods: Children <2 years of age (n = 1445) were screened and investigated for TB during a Bacille Calmette Guerin vaccine trial in South Africa. Standardized clinical, radiologic, and microbiologic data were collected, including paired gastric lavage and induced sputum for MTB liquid culture. Adjusted odds ratios (AORs) were calculated using a multivariate logistic regression model. Results: Adjusted odds of positive MTB culture increased by 90% with history of wheezing (AOR, 1.9) and by 4% with each 1-mm increase in Mantoux diameter (AOR, 1.04). Odds of positive MTB culture doubled if the chest radiograph was suggestive of pulmonary TB (AOR, 2.16) and more than tripled if lower chest retraction was observed clinically (AOR, 3.37). Fever, night sweats, and presence of lymphadenopathy were negatively associated with MTB culture (AOR: 0.5, 0.62, and 0.2, respectively). Persistent cough, weight loss, and failure to thrive were not significantly associated with MTB culture in this study population. Conclusions: Wheezing and lower chest retraction, consistent with intrathoracic airway obstruction; chest radiography suggestive of pulmonary tuberculosis; and Mantoux diameter were predictive of positive MTB culture. These variables should be considered for inclusion in composite clinical end point definitions for infant TB vaccine trials. Several clinical features, commonly used for TB diagnosis in older children, were not associated with positive MTB culture among children younger than 2 years. © 2012 Lippincott Williams & Wilkins.
Authors & Co-Authors
Luabeya, Angelique Kany Kany
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Mulenga, Humphrey
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Moyo, Sizulu
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Tameris, Michele D.
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Sikhondze, Welile
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Geldenhuys, Hennie D.
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Mohamed, Hassan
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Hanekom, Willem Albert
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Hussey, Greg Dudley
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Hatherill, Mark
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 10
Authors: 10
Affiliations: 2
Identifiers
Doi:
10.1097/INF.0b013e31823eeaf9
ISSN:
08913668
e-ISSN:
15320987
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
South Africa