Abstract:
Introduction Diagnosing tuberculosis (TB), including pulmonary tuberculosis (PTB), in children
remains a challenge, partly due to its paucibacillary nature in young children. Data on the use of line
probe assay (LPA), on gastric and sputum samples, for diagnosing PTB in children are scarce. We
determined the proportion of samples positive for Mycobacterium tuberculosis (MTB) by smear
microscopy (SM) and LPA in presumptive PTB cases as well as the factors associated with PTB
confirmed by LPA, in children in Jos, Nigeria.
Methods An observational study in children aged 6 months-16 years. Gastric and sputum samples
were examined by SM and by LPA for MTB using GenoType MTBDRplus Ver 2.0 (Hain Lifescience).
Multivariate logistic regression was performed to determine the factors associated with PTB.
Results Out of 103 children with presumptive PTB, 47 had confirmed PTB, 26 unconfirmed PTB
and 30 unlikely PTB by LPA. In 67 gastric samples, MTB was identified by SM in 2 (3.0%) compared to
28 (41.8%) by LPA while in 31 sputum samples, MTB was identified by SM in 5 (16.1%) compared to 18
(58.1%) by LPA. The factors associated with pulmonary tuberculosis were an abnormal chest X-ray
(adjusted odds ratio (AOR))=12.39 [3.75-40.90], p<0.001), sleeping in the same room with more than
three persons (AOR=3.30 [1.23-8.85], p=0.018) and sleeping in a room with none or one window
(AOR=2.86 [1.03-7.95], p=0.044).
Conclusions Line probe assay improves the diagnosis of pulmonary TB in children, especially with
gastric samples, while an abnormal chest X-ray is a useful adjunct in PTB diagnosis. Avoiding
overcrowding and having windows in sleeping rooms are a necessary part of TB prevention.
