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Detection of Mycobacterium tuberculosis in gastric aspirate and sputum collected from Ethiopian HIV‐positive and HIV‐negative children in a mixed in‐ and outpatient setting
Author(s) -
Palme I Berggren,
Gudetta B,
Bruchfeld J,
Eriksson M,
Giesecke J
Publication year - 2004
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2004.tb02953.x
Subject(s) - medicine , sputum , tuberculosis , mycobacterium tuberculosis , sputum culture , outpatient clinic , prospective cohort study , human immunodeficiency virus (hiv) , gastroenterology , immunology , pathology
Aim : To investigate, through a prospective study, the detection rate of Mycobacterium tuberculosis in sputa and gastric aspirate from tuberculous children in a low‐income country with high prevalence of tuberculosis and an increasing HIV epidemic. Methods : Gastric aspirates and/or sputum samples were collected from 355 children with pulmonary tuberculosis as follows: from 136 children under 5y only gastric aspirate was taken, for 159 children aged 5 to 9 y both methods were used, and for 60 children over 10 y only sputum was analysed. The diagnosis of tuberculosis was based on clinical data, tuberculin test and chest radiography. All children were tested for HIV infection. Results : Direct microscopy for acid‐fast bacilli was positive for 55 (15%) and mycobacterial culture for 183 (52%) children. The proportion of positive cultures was similar in all age groups. Among the 5 to 9 year‐old children who could produce a sputum sample, sputum gave just as good culture yield of M. tuberculosis as gastric aspirate. Of the clinical or radiological findings only weight loss was associated with a higher yield. Repeat gastric aspirate increased the culture yield by 6%. Mycobacterial culture from HIV‐positive children gave lower yield compared with HIV‐negative children. Conclusion : Our data suggest that one gastric aspirate for children less than 6 y and three sputum samples for the older children collected at an outpatient TB clinic, is enough to provide a close to 50% yield of M. tuberculosis available for culture and further analyses. However, with an increasing prevalence of HIV, this detection rate may be reduced.